top of page

Please fill out the form before you come to your appointment

Are you aware you are COVID-19 positive or are you waiting for a test result?
Do you have any of the following symptoms; hot/feverish, chills, recent loss of smell or taste, feeling tired or fatigued without explanation, new or worsening headache, cold or flu-like symptoms, runny nose or post-nasal drip?
Are you in public spaces or at work where you DON'T socially distance or wear a mask?
Is your workplace considered high risk?
In the past 14 days, have you returned from travel outside of BC, or attended a social gathering of more than six people?

Thank you for taking the time to complete the patient screening form, we look forward to seeing you at your appointment.

bottom of page