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Additional Intake form COVID-19 Due to the infectious nature of COVID-19, this additional intake form must be completed before each massage therapy session. Please know that people with COVID-19 can
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To fill out the Covid-19 intake form addendum, follow these steps:
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Start by downloading the Covid-19 intake form addendum.
03
Read all the instructions and questions carefully.
04
Provide accurate and up-to-date personal information, such as your name, address, contact details, and date of birth.
05
Answer all the Covid-19 specific questions, which may include your recent travel history, exposure to the virus, and any symptoms you might be experiencing.
06
If you have been vaccinated, provide details about the date and type of vaccine received.
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Ensure you understand the consent and authorization statements and provide your signature accordingly.
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Review your form for completeness and accuracy before submitting it.
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Submit the filled-out form through the designated submission channel, which could be an online portal, email, or in-person.
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Keep a copy of the filled-out form for your records.
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If you have any questions or need assistance, contact the designated authorities or healthcare providers.

Who needs covid-19 intake form addendum?

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The Covid-19 intake form addendum is required for individuals who:
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- Are seeking medical care or treatment in healthcare settings such as hospitals, clinics, or doctor's offices.
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- Have symptoms related to Covid-19 or are suspected of being exposed to the virus.
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- Are undergoing diagnostic tests related to Covid-19.
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- Are participating in Covid-19 research or clinical trials.
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- Are students, staff, or visitors entering educational institutions or workplaces that require the form for safety and tracking purposes.
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- Are traveling internationally or domestically to areas with active Covid-19 cases, as required by travel regulations.
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- Are being admitted to long-term care facilities or rehabilitation centers.
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It is important to note that the specific requirements for the form may vary depending on the jurisdiction and the specific context in which it is being used. Please refer to local guidelines and regulations for precise information.
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The covid-19 intake form addendum is a supplemental form used to provide information related to COVID-19 for intake purposes.
Employees and visitors to a facility are required to fill out the covid-19 intake form addendum.
The covid-19 intake form addendum can be filled out by providing accurate information regarding COVID-19 symptoms, exposure history, and travel history.
The purpose of the covid-19 intake form addendum is to gather information related to COVID-19 for screening and safety purposes.
Information to be reported on the covid-19 intake form addendum includes symptoms, exposure history, and travel history related to COVID-19.
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