How would you like to have your appointment?
| Are you currently experiencing any of these issues? | |
| Difficulty breathing or Shortness of Breath: | |
| Chest pain, Losing Consciousness or confused: | |
| Have you had Excessive sweeting: | |
| Fever above 37.8C or 100.4F or chills: | |
| Cough or barking cough: | |
| Runny or stuffy nose or nasal congestion: | |
| Decrease or Loss of taste or smell: | |
| Sore throat, trouble swallowing: | |
| Cold in last 2 weeks: | |
| Nausea, vomiting, diarrhea, abdominal pain: | |
| Not feeling well, extreme tiredness, sore muscles: | |
| Have you travelled outside of Canada in the past 14 days: | |
| Have you had Close contact with a confirmed or probable case of COVID 19: | |
| Have you done the COVID-19 test: |