Pre-appointment Check-in – Jordana Lorraine

Name *

Email address

Phone

Appointment actions

Confirm appointment with no changes to time or services

Request a change (Jordana will contact you within one business day)*

Cancel or reschedule appointment*

Change you'd like to request:

Are you currently feeling sick or experiencing any potential symptoms of Covid?

Yes

No

Have you had any known exposures to Covid, flu, etc. in the past 10 days?

Yes

No

Please share details here:

Masks are required in Jordana's suite

Confirm/Agree

A disposable mask will be provided if you do not have one that meets criteria in policy.