COVID-19 Form
Please read carefully and fill in the information prior to your appointment. Thanks!
Have you had close contact with anyone with acute respiratory illness or anyone who has traveled outside of Ontario within the last 14 days?
Do you have a confirmed case of COVID 19 or have you had close contact with a confirmed case of COVID-19?
Do you have any of the following symptoms:
If you are 70 years old or older and experiencing any of the following symptoms