COVID-19 PRE-SCREENING QUESTIONNAIRE

Please complete this screening form 24-48 hours in advance of your acupuncture appointment. 

Did you travel outside of Canada in the past 14 days?
Have you tested positive for COVID-19 OR had close contact with a confirmed case of COVID-19 without wearing appropriate PPE?
Do you have any of the following symptoms?
2.png
3.png
4.png
7.png
Blue and Brown How To Wear a Mask Corona
Colorful How to Wear a Mask Coronavirus