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?

CLINIC HOURS

TUESDAY  3:00 - 8:00pm

WEDNESDAY 12:00 - 5:00pm

SATURDAY 9:00am - 1:00pm

Contact for off hour appointment

ACUPUNCTURE CLINIC

75 Grandview Drive

CONESTOGO, ON N0B 1N0

INFO@KRISTAGEORGE.CA

 TEL.519-572-1115