COVID-19 Patient Consent Form

Please enter your first name here.
Please enter your last name here.
Please enter your phone number.
Have you or anyone in your household experienced any cold/flu or Covid symptoms in the last two weeks?
Have you been exposed to anyone who has tested positive for COVID-19 in the last two weeks?

If you have answered yes to either of these questions, please call the clinic directly at (250) 477-0240 as your appointment will need to be postponed.