CHW Treatment Safety Protocols for Patients and Staff

Be aware that when you come into the clinic you will be asked a series of questions to make sure it is safe for you to come in.  You will be asked whether:

  • You have recently had a fever (100.4+ is considered to be significant) or symptoms suggestive of fever, like chills, body aches, etc.
  • You have a recent onset of:
    • cough, not related to seasonal allergies
    • sore throat
    • shortness of breath without significant exertion
    • digestive complaints (including vomiting or diarrhea)
    • loss of taste or smell.
  • You have, or suspect you have COVID-19 infection.
  • You have tested positive for COVID-19, or are awaiting the results of tests for COVID-19.
  • You have been recently exposed to someone who either has, or is suspected of having, COVID-19 infection.

If you answer “yes” to any of these questions, we will not be able to care for you at this time and will suggest that you do one of the following before you return for care:

  • If you have or suspect you have COVID- 19 infection, you should wait 5 days from the time of exposure before getting a COVID test and, if negative, you are welcome to return for care. If you test positive you should wait 14 days from the time of exposure to return for care.


  • If you have tested positive for COVID-19, you must wait 14 days from the date of exposure or the onset of symptoms before returning to the clinic.


  • If you are awaiting the results of a COVID test, you must wait until your test results are in and, if you are positive, you must wait 14 days before returning for care. On the other hand, if you test negative, you may return to the clinic provided the test that you had done was taken at least 5 days after suspected exposure. Because the viral load builds gradually after infection, it takes an average of 5 days from the time of exposure to when a COVID test will come back positive.


  • If you have been exposed to someone who either has, or is suspected of having, COVID-19 infection you should wait 5 days from the time of exposure to get a test and, if negative, you may return for care. If you test positive, then you must wait 14 days from the time of exposure until you return for care.

The reason for the above precautions is that it can take some time from when you are exposed to COVID-19 to when you either develop symptoms or become contagious yourself.  The average length of time it takes for a person to develop symptoms after exposure is 5 days. That is also the length of time it takes for the viral load to build sufficiently for a COVID test to be positive.  On average a person has sufficient viral load to be contagious 2 days before the onset of symptoms.  What this means is that you can be exposed, get infected and then become contagious a couple of days before you develop symptoms and would have a positive test.  People remain contagious for a period of time after they become symptomatic. Given the variability, both in the time it takes to develop symptoms and in the length of time that a person remains contagious, it has been considered prudent to quarantine for 14 days from the time you develop symptoms.  The CDC has recently updated this guidance to shorten the time of quarantine, but I have seen no good evidence that this new guidance is well-grounded in infectious disease reality.

The procedures that we will be using to protect you and our staff are outlined below:


  • We will be staggering Doctors’ schedules and appointment times to facilitate social distancing. This may mean that our capacity to care for patients during peak hours of demand will be reduced and may necessitate that you schedule in advance for those peak hours.


  • If you wish to do so, you may choose to wait for your appointment in your car; this is not a requirement.  If you prefer to do so, when you arrive in our parking lot you will simply call or text the front desk to let us know you have arrived and are ready for your appointment. When the doctor is ready for you the front desk will call or text and let you know to come in.


  • The front door to the building has an electronic door opener which you can operate with your hip or elbow. We suggest you use this for entering and leaving the building.


  • Before you enter the clinic we ask that you wash your hands in the bathrooms that are on either side of the elevators, or that you use hand sanitizer that is available in the lobby of the building by the elevators or in the clinic.  The bathrooms also have automated doors that can be opened with a hip or elbow.


  • We will be leaving our front door open so that you do not have to touch the doorknob coming in or going out. (Sorry, this also means that our puppy friends will not be joining us in the clinic for a while.)


  • We will take your temperature when you come in. Once again, we want to make sure that our staff and other patients are not unwittingly exposed. If you have a fever (temperature in excess of 100.4), we will not be able to care for you on that day. We will ask that you go home, quarantine, and do one of the actions outlined above


  • Additionally, one of the staff will be asking you the questions outlined above.  As previously noted, if you answer “yes” to any of these questions, we will not be able to see you that day and will request that you take one of the previously stated actions before returning for care.


  • We will be wearing face coverings (masks) and ask that you do likewise.  If you do not happen to have one, we will provide a sanitized and reusable cloth mask which you may use while in the clinic and then drop in a hamper when you depart. The reason we feel that face coverings are important is that they prevent droplet spread of the virus when you cough, sneeze or speak.


  • We will observe strict hand washing/sanitization before we touch you.


  • We are providing a sanitized stylus (which will be in a “clean” bin next to the iPad) for to you use when you sign in. When you finish signing in you will place your used stylus in the “used” bin.


  • We will provide appropriate social distancing in the reception and waiting areas. The chair arms and all “touch points” within the clinic will be regularly sanitized.


  • In order to provide a sanitary treatment surface for you we sanitize each table after each use and then cover that table with a freshly laundered sheet.


  • We ask that you not bring other family members with you for your appointment, unless they are also being treated. The idea here is that we want to limit those coming through the doors to those that are being treated and thus minimize the potential for exposure.


  • We ask that you not linger or lean on the front desk counter and will ask that, if you have not already done so, you leave a credit card number on the account. Your card will then be charged for your appointment when you leave. If you need to pay by credit card or check at the time of the appointment, we will have facility to sanitize both using ultraviolet light sanitizers, however we prefer to keep all transactions ‘paperless’ as much as possible.


  • All therapy and rehab equipment will be sanitized or covered with protective coverings before each use.


  • And finally, we ask for your understanding and patience during this new and uncertain time. We have tried to think of everything that we can do to protect you and our staff, and welcome your suggestions and/or comments.

We apologize for any inconvenience that these procedures might cause you, but, rest assured, we are taking these measures to protect both you and our staff. If you have some special circumstances, please let us know and we will do everything possible to accommodate your needs.  If you have any questions or concerns about any of our policies or procedures, do not hesitate to contact the doctors or Nancy.  We love and appreciate you and look forward to getting back to a new “normal”.