604 536 7606 ext. 2
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Click to View Our Pandemic Safety Plan
Pre-Appointment COVID-19 Screening and Arrival Instructions
You must
complete and submit this questionnaire BEFORE your appointment
; note that we will ask these same questions at the start of your appointment.
Only
essential people
(e.g translator, advocate) may also attend the appointment with you; they must also complete the screening questions separately.
Arrival Instructions:
Wait in your car
until your appointment time.
Arrive as
close to your appointment time
as possible; we have limited seating and must manage the flow of people coming and going. But, we can always accommodate people with disabilities and those needing extra time or assistance.
You are required to wear a
mask
on arrival.
*
Indicates required field
Name
*
First
Last
Email
*
Phone Number
*
Are you experiencing cold, flu or COVID-19-like symptoms, even mild ones? Symptoms include: fever, chills, cough, shortness of breath, sore throat and painful swallowing, stuffy or runny nose, loss of sense of smell, headache, muscle aches, fatigue or loss of appetite.
*
No
Yes
Have you travelled to any countries outside Canada, including the USA, within the last 14 days?
*
No
Yes
Did you provide care or have close contact with a person with confirmed COVID-19? Note: This means you would have been contacted by your health authority’s public health team.
*
No
Yes
Submit