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IT'S ALL HERE, CONTACT US TODAY: 519-574-8600

PERSONAL INFORMATION

SELF-SCREENING QUESTIONNAIRE

Please check off each square if you are NOT currenty experiencing any of these symptoms:
Please check off each square if you are NOT in any of thse at-risk groups?
Have you, or anyone in your household, traveled outside of Canada in the last 14-days?
Have you, or anyone in your household, had close, unprotected contact wit someone who is ill with cough and/or fever?
Have you, or anyone in your household, been in close, unprotected contact in the last 14-days with somene who is being investigated or confirmed to have a case of COVID-19?

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