Please fill out the following health questionnaire prior to coming in for your appointment.
OR Download, Fill & Print the questionnaire and bring it to your next appointment.
• New onset of cough
• Worsening chronic cough
• Shortness of breath
• Difficulty breathing
• Sore throat
• Difficulty swallowing
• Decrease of loss of sense of taste or smell
• Unexplained fatigue/malaise/muscle aches (myalgias)
• Nausea/vomiting, diarrhea, abdominal pain
• Pink eye (conjunctivitis)
• Runny nose or nasal congestion without other known cause
C-4 15 Beaumaris Drive
ON L6T 0J3
Mon: 10AM-7PM Tues: 10AM-7PM Wed: CLOSED Thurs: 10AM-7PM Fri: 10AM-6PM Sat: 9AM-3PM Sun: CLOSED
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