COVID Questionnaire prior to In-Person Appointment

For the health and safety of our patients and staff, please complete this questionnaire the day before or the same day before coming in for your in-person appointment. We prefer that patients enter alone if possible. However, if you require a support person to accompany you, please have them complete this questionnaire separately.

Please wear a mask when you come to the office for your in-person appointment. Call us from the parking lot when you arrive. 905-889-3634

Thank you for your cooperation.


Only complete this questionnaire as early as one (1) day prior to your appointment.

* indicates required field












Top