Symptom Screening Questionnaire

Each person participating in an in-person appointment/entering an office space must complete the symptom screening, no earlier than one day prior to your visit. Each person must complete all questions on the symptom screening questionnaire.


 

If you have answered NO to all the questions above you are permitted to proceed with your in-person/in-office appointment. 

If you have answered YES to any of the questions above,  you are not permitted to proceed with your in-person/in-office appointment. You should complete the provincial COVID-19 self-assessment at https://covid-19.ontario.ca/self-assessment. This will provide you with a recommendation of what to do next. If you need support to complete this assessment, please let your clinician know. 

Please contact your clinician to reschedule your appointment.