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The Healing Zone Pre-Appointment Check-In
Please fill this out within 24 hours of your scheduled appointment.
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Email
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Your email
Your Name
*
Your answer
Today's Date
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MM
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DD
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Have you been vaccinated? Please bring a copy of your vaccination record if possible.
*
One Dose (Pfizer or Moderna)
Not Vaccinated
Both Doses (Pfizer or Moderna) - at least 2 weeks past 2nd shot PLUS BOOSTER
Janssen Single Dose - at least 2 weeks past PLUS BOOSTER
Fully vaccinated but BOOSTER not yet received
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