COVID19

Pre-Appointment COVID-19 Screening and Arrival Instructions

You must complete and submit this screening questionnaire BEFORE your appointment. Note: 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:

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.
Masks are recommended for everyone aged 12 and over until you are fully vaccinated approximately 2 weeks after your second dose. Please do your part to keep each other safe.
Maintain physical distancing.
Be respectful and kind as you consider others' situations and personal choices.

* Indicates required field

Name *

First

Last

Email *

Phone Number *

Are you experiencing cold, flu or COVID-19-like symptoms, even mild ones? *

Are you under self-isolation or quarantine orders because of contact-tracing or international travel? Note: These are given by public health or border officials. *

Submit