A pre-screening questionnaire will be sent to the patient within 24 hours prior to the appointment.  Patients are to refrain from visiting the clinic if exhibiting any COVID-19 symptoms identified on the questionnaire.

The following precautions will be practiced in the entry / reception area:

• The entry door will be open and the patient will be greeted by the RMT.
• The entry area will be free of clutter.
• Physical distancing of 2 metres (6 feet) between RMT and patient will be maintained outside the treatment room.
• The RMT will inquire whether anything has changed since the patient has filled out the pre-screening questionnaire.
• Patients are encouraged to ask questions about the RMT's physical distancing practices or express any other concerns they may have.
• Appointments will have 30 minutes between them to minimize the potential for person-to-person contact between patients.
• If possible, patient will arrive unaccompanied; unless patient is a minor who requires parent/guardian, or needs assistance.
• At end of treatment, RMT will accompany the patient to the exit and open the door using a hand towel or other sanitized barrier.

Reception

• Patient washes hands upon entry with soap and water for at least 20 seconds, followed by thorough drying – must be done on arrival into and departure from the clinic.
• If soap and water are not available, provide sanitation station with alcohol-based hand rubs for patient’s use on arrival and prior to departure.
• If hands are visibly soiled, patient must use a wipe, then alcohol-based hand rub prior to moving to the treatment room.
• RMT must wash hands often, using soap and water for a minimum of 20 seconds each time.
• Hand-washing protocols are posted visibly in reception area and at sinks; including bathroom for patient’s use.
• If payment occurs in the reception area, a wireless point of sale system with tap feature may be used or arrange e-transfer for payment. Receipt is emailed to patient. Cash is not preferred but may be handled provided that anyone doing so washes their hands immediately afterwards.

Treatment Room

• It is not possible to maintain physical distancing in the treatment room.
• RMT opens the door to the treatment room and allows patient to enter; RMT opens/closes door before, during, and after treatment as required, using hand towel/sanitized barrier as needed, and washing hands as appropriate.
• Hand washing/drying and sanitation options should be available for RMT and patient.
• Hand washing should occur before and after treatment; both RMT and patient.
• Attach safety posters from BC Centre for Disease Control next to sink, setting out proper hand washing guidelines; soap and water for 20 seconds and drying hands thoroughly.

• Share information about the reason for avoiding the face during a treatment; coronavirus can be spread by touch if a person has used their hands to cover a cough or a sneeze.
• Suggest patients use a tissue if an itch must be addressed.
• Tissues must be available for patient’s use in reception, treatment room, washroom.
• Masks must be made available for patient and for RMT, because masks are useful to avoid touching face.
• RMT makes use of hand towel or tissue to touch or scratch face, or to sneeze into.

• Training for therapists and staff in sanitation processes.
• Clean visibly soiled surfaces followed by disinfection.
• Clean and disinfect all high-touch surfaces in between patients, regardless of appearance.
• Linens and blankets are single use only, then laundered in hot soapy water.
• Frequently clean and disinfect common areas and high touch surfaces, at least twice a day, e.g. light switches, window coverings, cell phones, tablets, chairs, stools, table surfaces.
• Frequently clean and disinfect at least three times per day:
  • handles: doors, cabinets, faucets, fridge, microwave, etc.
  • electronic device keyboards and mice, phones,
  • arm rests of chairs,
  • desk and table surfaces.
• Clean in view of patients so patients see the steps taken for safety.
• Schedule additional time between patients to thoroughly clean treatment room.
• Sanitize the treatment table, face cradle and table adjustment levers after each treatment.
• Clean equipment and supplies; table levers, lotion bottles immediately after each patient.
• Cease use of thermophores.
• Attach Cleaning and Disinfectants for Clinic Settings poster from the BC Centre for Disease Control in reception area, washroom for patient use, treatment room.
• All contact areas must be cleaned several times a day; doors, washrooms, massage table surfaces.
• Provide wipes if available.
• If wipes are unavailable, provide paper towels or tissues for patients to use as a barrier when contacting high-touch surfaces.
• Maintain good air flow in all areas of the clinic

• RMT must address the issue of mask use with patient; by RMT, by patient, or both.
• Mask use is not mandatory, but RMT must have cloth or paper/disposable surgical masks available for patient’s use if requested, and for RMT’s use if patient requests it. Cloth masks must be laundered after each use.
• Respect a patient’s individual personal boundaries and support their requests for PPE to be worn by either individual.
• If a cloth mask is offered to a patient, it must be evident that the mask is clean and has not been worn by others.
• If either party feels that additional risk mitigation is necessary, a decision to wear a mask at that point is one way forward.
• Donning and doffing mask: wash hands with soap and water prior to putting on a mask, prior to taking off a mask, and after disposing of a mask in the laundry or garbage.
• The patient consents to treatment despite some risk; and
• The RMT will document the patient’s consent.