Covid-19 Questionnaire - The Vancouver Facialist

Covid-19 Screening Questionnaire

Please answer the questions below, to help with safety, screening and contact tracing protocols

Question 1

I have not had any symptoms of COVID-19 (Symptoms include fever, chills, new or worsening cough, shortness of breath, sore throat, loss of taste of smell, vomiting or diarrhea, and new muscle aches or headaches.)

Question 2

I am not waiting for the results of a laboratory test for the novel coronavirus

Question 3

I have not been around anyone who has symptoms of COVID-19

Question 4

I have not been out of Canada in the last 14 days

Question 5

I have not been around anyone that has been out of Canada in the last 14 days

Question 6

I have not been to any large gatherings where social distancing was not observed

Question 7

I confirm that I am not currently positive for the novel coronavirus

Question 8

I understand that the BC Centre for Disease Control has asked individuals to maintain physical distancing of at least 2 meters (6 feet) and that it is not possible to maintain this distance and receive aesthetic medicine treatment

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Covid-19 Screening Questionnaire

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