COVID Screening Form

Welcome to our clinic!
Please take a few minutes to fill out this form as completely as you can.
If you have any questions we’ll be glad to help you.

Have you/they travelled outside of Canada in the past 14 days?
Have you/they tested positive for COVID-19 or had close contact with a confirmed case of COVID-19 without wearing appropriate PPE? Patients who are well but who have a sick family member at home with COVID-19 should consider postponing elective treatment.
Do you/they have any of the following symptoms? Fever, cough, worsening chronic cough, shortness of breath, difficulty breathing, sore throat, difficulty swallowing, decrease or loss of taste and smell, chills, headaches, unexplained fatigue/malaise/muscle aches, nausea/vomiting, diarrhea, abdominal pain, pink eye (conjuntivitis), runny nose or nasal congestion without other known cause?
If you/they are 70 years of age or older, are you/they experiencing any of the following symptoms? Delirium, unexplained or increased number of falls, acute functional decline, or worsening of chronic conditions?

HOURS

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Tuesday

Wednesday

Thursday

Friday

Saturday

Sunday

Closed

8am - 5pm

8am - 5pm

9am - 6pm

8am - 5pm

On appointment

Closed

NAVIGATION

FLOW DENTAL CARE

(905) 901-1802

Dental Emergencies: (905) 464-4888

101 - 418 Iroquois Shore Rd

Oakville ON L6H 0X7

info@flowdentalcare.ca

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