COVID-19 Forms

Welcome Back | COVID-19 Forms

Forms:

#1. Patient Consent and Acknowledgement form. [ DOWNLOAD ]

#2. Patient Pre-Screening form. [ DOWNLOAD ]

 

Instructions for Form(s):

  1. Please save the following fillable forms(s) to your computer.

  2. Open and complete the form(s).

  3. Please ensure the information entered has been saved to the forms prior to submitting.

To submit the forms you can either email the completed form(s) to [email protected] or print and bring them to your next appointment.

In order to view or print these forms you will need Adobe Acrobat Reader installed. Click here to download it: Get Adobe Reader

Our Locations

Georgetown Office (905) 877-0145

Orangeville Office (519) 941-8210

Hours

Monday:

8:00 am-4:30 pm

Tuesday:

8:00 am-4:30 pm

Wednesday:

8:00 am-4:30 pm

Thursday:

8:00 am-4:30 pm

Friday:

Administrative Day

Saturday:

Closed

Sunday:

Closed

Send Us an Email