Below are the screening questions you will answer prior to arriving and at the time of your scheduled appointment:
If responses pass ALL of the screening questions: Proceed with treatment
If responses to ANY of the screening questions fail: Postpone Treatment
PATIENT SCREENING QUESTIONNAIRE (SAMPLE)
I have access to a mask (i.e fabric, surgical, N95 or some form of face covering) that I will wear to my scheduled appointment.
I understand that, in an effort to decrease soiled items, chiropractic patients who typically use medical gowns/shorts will bring/wear appropriate attire (i.e. tank top, shorts, loose clothing etc.) that allow access to the treatable area (if needed)
I will not enter the facility more than 5 minutes prior to my scheduled appointment. Additionally, I acknowledge that if I am late to my appointment, my practitioner may not be able to accommodate my visit due to new clinic policies.
Despite necessary measures and precautions (i.e. PPE, sanitization, social distancing etc.), I acknowledge the contagious nature of COVID-19. I assume the risk that I may be exposed by attending an in-person treatment at Bayside Wellness.
Have you recently (in the past 14 days) or currently been experiencing any of the following symptoms?
Cough, fever/chills, sore throat, runny nose, difficulty breathing or shortness of breath, chest pain, loss of taste or smell, loss of consciousness, delirium, nausea, vomiting, or diarrhea.
In regards to the above symptoms:Have you been in close contact with a confirmed case of COVID-19 or anyone currently sick with the above symptoms? Or anyone who has travelled outside of Ontario in the past 14 days?
Have you traveled outside of Ontario in the past 14 days?