Patient Pre-Screening

As per Provincial regulations, you must complete a pre-screening questionnaire at least 48 hours prior to your next appointment.

Please start by visiting the following website – – to familiarize yourself with the most up to date list of potential COVID exposure locations, and whether or not you may have visited any of those locations during the potential exposure window.

Then answer the pre-screening questions below, sign, and submit the form.

In the event your condition and your answers to any of the following questions change between now and your next scheduled appointment, you MUST advise our office as soon as possible. 


  • If you did not review the list prior to starting this survey, please click the link at the top of this page and do so before proceeding.
  • Signature