COVID Screening Form Visitor Name (required) Visitor Contact Number (required) Are you exhibiting any of the following symptoms? Fever or chills YesNo Difficulty breathing or shortness of breath YesNo Cough YesNo Sore throat, trouble swallowing YesNo Runny nose / stuffy nose or nasal congestion YesNo Decrease or loss of smell or taste YesNo Nausea, vomiting, diarrhea, abdominal pain YesNo Not feeling well, extreme tiredness, sore muscles YesNo Have you travelled outside of Canada in the past 14 days? YesNo Have you had close contact with a confirmed or probable case of COVID-19 YesNo Did you answer yes to any of the previous questions? YesNo Digital Signature here Results of Screening Questions: - If you answered YES to any questions, we recommend you do not bring your pet to the clinic for the appointment. For the safety of our staff and our community we ask that you have someone else bring the pet, who does not answer YES to any of the above questions. - If you answered NO to any questions, we ask that you wear a mask when interacting with our staff. We ask that you bring your dog on a leash and your cats in a carrier. Once you arrive at the clinic please call us and let us know what spot you are parked in. Our technician will call you back when we are ready to examine your pet. Then you can bring you pet to our door where our staff will greet you and take the pet into the building. - If you have any questions regarding our COVID regulations please call us at 519-776-7325. Δ
