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Office Location

395 Greenbrook Drive Suite 27
Kitchener, Ontario N2M 4K1

Please fill in the following appointment form

    COVID-19 Screening Questions

    To help us prevent the spread of COVID-19, we ask you to read this carefully and answer the questions below.

      Are you experiencing any symptoms?

      Has anyone in your household experienced any symptoms in the past 14 days? (Note: if the symptomatic person in your household has received a negative COVID-19 test result, please answer ‘no’)

      In the past 14 days, have you been identified as a close contact of someone with suspected or confirmed COVID-19?

      Have you travelled outside Canada in the past 14 days or been in contact with anyone who has travelled outside Canada in the past 14 days?

      Have you experienced any symptoms since you were 5 last at the site?

      Has it been at least 10 days since your symptoms started?

      Have you been symptom free for at least 48 hours?