Dear CWC Community,
We are OPENING, safely…
We are currently accepting in-person acupuncture appointments — mindfully and carefully. We have truly missed working with and seeing you all, and for those of you whom we have only met virtually, we look forward to seeing you in our office.
Please review and submit these forms:
- #1 – Fill out this form only once. Starting May 19th each patient must submit this form. Assumption of the Risk and Waiver of Liability Relating to Coronavirus/COVID-19
- #2 – Fill out this form the day before EACH appointment. COVID-19 Agreement and Screening Questionnaire
We will call you right before your appointment to confirm that nothing in your health screening has changed. We will then meet you outside our front door to take your temperature before you enter the office. You must bring and wear a mask that covers your mouth and nose at all times.
Guidelines for keeping our community safe:
1. Symptom Screening:
If you are sick in any way, including fever, body aches, sore throat, sinus issues (even if you think it’s “just allergies”), or uncommon digestive upset, please do not schedule or keep your in-person appointment. We can always help you virtually. Just call the front desk at 512-968-2605 and we will assist you.
To keep everybody safe, all patients will be pre-screened the day before as well as the day of their appointment to verify that they are symptom-free and have not been exposed to anyone with symptoms or known illness. Please see the Assumption of the Risk and Waiver of Liability Relating to COVID-19 and Screening Questionnaire below.
All visitors will be required to bring and wear a mask covering their mouth and nose at all times, no exceptions. All of our practitioners and staff will also be masked.
3. Safety and Sanitation:
We are following best practices as outlined by the CDC and professional governing bodies. They include the following:
Appointments are arranged to ensure minimal, if any, contact between you and anyone other than your practitioner and our front desk staff.
To keep non-essential contact to a minimum, the parking lot is the new waiting room. We will call you to screen for any updates to your health, meet you at the door for a temperature check and invite you to come inside. Only patients receiving treatment are allowed inside the building.
You will be directed to immediately wash your hands for 20 seconds with soap and water before going to the treatment room and lying down on the table to wait for your practitioner. We ask that you leave all non-essential items at home or in your car.
While you are receiving your acupuncture treatment you will have an opportunity (as always), to give us updates on your health or request supplement refills. However, if you have questions or would like to have a more in-depth discussion, please schedule a telehealth consultation (by calling 512-387-0891).
All rooms and frequently touched surfaces will be disinfected before and after each patient’s visit.
We will have a touch-less check-out as per usual. If you have a new credit card, or for some other reason need to update your card, please let us know before your appointment so that the front desk staff can arrange to do this over the phone.
In order to maintain proper social distancing in our waiting area, if you need an herb or supplement order filled and are not coming in to receive acupuncture, please call ahead of time and we will leave your order in a bag outside the door. We can charge your card on file, or collect payment over the phone.
4. Virtual Telehealth Visits:
This is a great option for patients who feel best receiving care from home.
What we do during a virtual visit:
- Follow-up care and modifications for pre-existing treatment plans.
- New and on-going diet, lifestyle, and herbal/supplement prescriptions for cancer support, including concerns such as insomnia, anxiety, digestion, pain, and immune support.
- At home self-care plans including cancer management and emotional wellness.
- Immunity check-ins: herb and supplement support and self-care plans.
Thank you for your understanding and patience during this challenging time and for any changes that may evolve in the upcoming weeks.
We look forward to seeing you soon!
Assumption of the Risk and Waiver of Liability Relating to Coronavirus/COVID-19
The novel coronavirus, COVID-19, has been declared a worldwide pandemic by the World Health Organization. COVID-19 is extremely contagious and is believed to spread mainly from person-to-person contact. As a result, federal, state, and local governments and federal and state health agencies recommend social distancing and have, in many locations, prohibited the congregation of groups of people.
Sage Acupuncture LLC and The Cancer Wellness Center (the “Practice”) has put in place preventative measures to reduce the spread of COVID-19; however, the Practice cannot guarantee that you will not become infected with COVID-19 or that you are not already an asymptomatic carrier of COVID-19. Further, receiving services at the Practice could increase your risk of contracting COVID-19.
By signing this agreement, I acknowledge the contagious nature of COVID-19 and voluntarily assume the risk that I may be exposed to or infected by COVID-19 by receiving services at the Practice and that such exposure or infection may result in personal injury, illness, permanent disability, and death. I understand that the risk of becoming exposed to or infected by COVID-19 at the Practice may result from the actions, omissions, or negligence of myself and others, including, but not limited to, Practice owners and employees.
In consideration for being permitted to receive services at the Practice, I voluntarily agree to assume all of the foregoing risks and accept sole responsibility for any injury to myself (including, but not limited to, personal injury, disability, and death), illness, damage, loss, claim, liability, or expense, of any kind, that I may experience or incur in connection with receiving services at the Practice. On my behalf, and on behalf of my heirs, executors, administrators, personal representatives, and assigns, I hereby release, covenant not to sue, discharge, and hold harmless the Practice, its employees, agents, and representatives, of and from any claims, including all liabilities, claims, actions, damages, costs or expenses of any kind arising out of or relating thereto. I understand and agree that this release includes any claims based on the actions, omissions, or negligence of the Practice, its employees, agents, and representatives, whether a COVID-19 infection occurs before, during, or after receiving services at the Practice.
COVID-19 Agreement and Screening Questionnaire
Please note that for the safety of our staff and other patients, all persons in our office must agree and comply with the following.
While on the Practice premises I agree to:
- Come unattended to the office.
- Once directed, wait for a staff member outside the front door.
- Maintain a distance of six (6) feet from other persons whenever possible.
- Bring and wear a face mask, that covers my nose and mouth, the entire time that I am in the clinic.
- Wash my hands for 20 seconds upon arrival and maintain proper hand hygiene.
- Practice proper cough & sneeze etiquette by coughing/sneezing into my elbow.
- Remain in areas designated for my visit.
Answer the following Yes or No questions:
____I have been exposed to a person with a suspected or lab-confirmed case of COVID-19 within the past 14 days.
____I have had a fever of over 100.4°F/38°C in the last 72 hours.
____I have had symptoms of respiratory illness (fever, sore throat, cough, shortness of breath, etc), or other symptoms associated with COVID-19 in the last 72 hours.
____I have had a loss of sense of smell or change in taste in the last 72 hours
____I have been in groups of more than five (excluding my immediate household), in the past 14 days.
____I have traveled by air in the past 14 days.
If you answered “Yes” to any of the above questions, we are not able to treat you at this time.
I confirm that I understand, and agree to the Assumption of the Risk and Waiver of Liability Relating to Coronavirus/COVID-19. Furthermore, I confirm that I have answered the screening questions truthfully.