You are welcome to copy and use this template – MHConcierge.

We are carefully monitoring information about COVID 19, or the Corona Virus, in Minnesota. We understand that there is a lot of anxiety and confusion about the virus. While it is not yet established in our community, it is evident that there is a risk of this that we all must consider. Here is what we are doing to minimize risk in our office

  • We ask that if you are ill with any potential COVID 19 (or flu) symptoms (coughing, sneezing, runny nose and fever)  or have been exposed to someone known to have COVID 19, please cancel your appointment. We will also not be in the office if we have any symptoms. Patients/clients who present to the office with symptoms will be asked to leave  – for our sake and also the sake of others. 
  • If you need to cancel due to symptoms, or due to being exposed to someone known to have COVID 19, there will not be a late cancellation fee – even at the last minute. 
  • We respectfully decline to shake hands, and enthusiastically endorse use of the fist or elbow bump.
  • A bottle of hand sanitizing fluid is provided in the waiting room. Please feel free to use it.
  • If possible, cough or sneeze into a disposable tissue and discard. Use your elbow only if you have to. According to medical experts, the clothing you cough or sneeze into will harbor the infectious virus for up to a week or more.
  • If COVID 19 is reliably documented to be in our community, we will sanitize commonly shared surfaces (door knobs, light switches, chair arms, tables , etc) daily. If someone who may be ill has been in the office, we immediately re-sanitize.
  • If you are feeling sick, you have the option of telehealth (video) appointments instead of in-person appointments.  Minnesota law requires insurance companies to pay for telehealth in the same manner as in-person sessions.  Medicare, however, is not covered and generally does not cover telehealth for mental health services. Also, some insurance companies have requirements for telehealth, so if you should contact your insurance company to find out whether there would be any problem with you having telehealth appointments. Phone calls are generally not covered for therapy by insurance.


3 thoughts on “Covid 19 office document template

  • March 9, 2020 at 3:09 pm

    Thank you for providing this template, very helpful!

  • May 18, 2020 at 2:21 pm

    Thank you. Are you requiring your clients to wear masks? Will you require temperature checks or other screenings before entry into your office/clinic setting?
    Will you see multiple people in your office at one time?

    • May 18, 2020 at 3:54 pm

      Hi, Cindy is asking excellent questions – there is a lively discussion on many professional listservs about these issues. I am not resuming in-person app’ts, but if I were resuming in-person app’ts I would: have only one person in the office at a time, require a facemask, and request that they take their temp before coming in (an not come in if it is over 100), and require that they not come in if they have any symptoms. But, I have a small practice and usually have only one person in the waiting room at a time. Therapists in group practices would have to evaluate what would work for their clinic.


Leave a Reply to Cindy Dolby Nollette Cancel reply

Your email address will not be published. Required fields are marked *

This site uses Akismet to reduce spam. Learn how your comment data is processed.