Statement of good faith

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During your first appointment you will be asked to sign our health statement :

By signing below I acknowledge that the following symptoms have been reviewed with me by my therapist.  I also acknowledge, to the best of my ability, that I remain symptom free and attest that I have not encountered the following symptoms.  I also offer a good faith promise to alert my therapist if I am sick and cannot make it into session or if I would like to transition to any form of telehealth therapy. 


Fever 
Chronic headaches within the last 14 days 
Dry cough that is persistent
Labored or trouble breathing 
Increased phlegm
Chills within the last 14 days 
Fatigue within the last 14 days 
Travel within the 14 days

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