COVID Screening Form

    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.