COVID-19 SampleQuestionnaire & Agreement:

By attending my appointment

I agree that I am not currently experiencing any of these symptoms:

  • Cough
  • Shortness of breath or difficulty breathing

I agree that I am not experiencing two or more of these symptoms:

  • Fever
  • Chills
  • Repeated shaking with chills
  • Muscle pain with accompanying fever/chills, sore throat etc. 
  • Headache
  • Sore throat
  • New loss of taste or smell

I agree that I have not:

  • Tested positive for COVID-19
  • Knowingly been exposed to someone with COVID-19
  • Recently traveled to an area with a high infection rate
  • Been in an area where social distancing was not properly observed
  • Been to a nursing home 

If you have experienced any of the above, please reschedule your appointment at least 14 days from now.


Style of treatment. While I can provide treatment with the client draped and use lotion, there are other options available for those who might feel more comfortable remaining dressed and/or seek alternative approaches to treatment.

For many years now I have treated a large percentage of my clientele dressed in loose clothing or athletic wear. This style of treatment incorporates a number of osteopathic techniques, plus various forms of stretching, along with some kneading and acupressure. It is based on what once was called “General Osteopathic Treatment” in North America, and on the British version called the “Total Body Adjustment”. Use of gentle percussive devices have often been employed by me as well during such treatments.

Such treatments are usually 30 or 45 minutes long. This approach is highly effective for all types of musculoskeletal issues as well as circulatory & lymphatic concerns, and also be employed for basic stress relief and relaxation.

Most of my clients over the years have remarked that my style of massage is somewhat unique when receiving massage with draping and lotions, and this is so because a number of the techniques mentioned above have been incorporated into my treatment approach. Therefore, if you are a client who previously received only draped treatments with me many of the elements of a dressed treatment may well be familiar to you. Please specify upon arrival (or in an email prior to arrival) that you wish the dressed form of treatment if that is not the usual manner in which I have treated you in the past.

David Zulak RMT

For how long is dependent on how the pandemic demands self-isolating and social distancing. how long is dependent on how the pandemic demands self-isolating and social distancing.