Prior to attending your appointment, please answer Yes or No to the below questions and provide any relevant comments.
Please Proceed to answer the below questions
- Name & Email
- Covid Questionnaire - Step 1
- COVID Questionnaire - Step Three
First & Last Name
Step 1 COVID Questions
Do you have any condition or illness whereby your immunity might be compromised (cancer, diabetes etc)?
Does anyone you live with, or have regular contact with, have an illness whereby their immunity might be compromised (cancer, diabetes etc)?
Have you tested positive for Covid-19 in the last 14 days?
If you answer “Yes” to any of these questions, you may be asked to delay your appointment and come into the practice when the risk of Covid-19 infection to you is less. Virus infection is potentially more severe and dangerous for you; so try to stay at home for now.