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COVID-19 Questionnaire

Please have the questionnaire completed prior to your arrival.

To preserve the health of our clients and employees, please complete the following assessment. Your responses will help us prevent any unnecessary exposures. Please let us know if you have any questions. Thank you!

Contact us

617-394-0900 calls and texts

781-396-0900 calls only 


44 High street, Medford, MA

Do you have a fever,or have you felt feverish recently?
Do you have a cough?
Are you having shortness of breath or any diffculty breathing?
Do you have chills or repeated shaking with chills?
Do you have any muscle pain?
Do you have any recent onset of headache or sore throat?
Do you have any other flu-like symptoms?
Do you have any recent loss of taste or smell?

Thanks! Message sent.

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