COVID-19 Questionnaire

For appointments with a veterinarian, one adult may accompany their furry family member into the exam room. For all other appointment types, we encourage our neighbors to take advantage of curbside service whenever possible. However, our front park is open to a small number of visitors if necessary.

Anyone who enters the building must sanitize their hands upon entry, pass a COVID-19 questionnaire, and wear a mask properly for the full duration of their time inside.

If you wish to enter the building, please complete the following steps:

If you haven’t already, please check in with a team member at the front door. We ask that you wear a mask while interacting with our team.
Complete and submit the following COVID-19 form.
If you answer yes to any of the following questions, please let a team member know immediately or call 519-649-0080 for assistance.

Some exceptions can be made for individuals to enter the building. In this case, you must notify us PRIOR to entering the building if you have traveled recently, are feeling ill, or have been in contact with any individuals who are COVID-positive or are experiencing symptoms of COVID-19.

Which location are you checking into? *

North London (746 Waterloo St)
Westmount (851 Wonderland Rd S)

Name *

First

Last

Furry Family Member's Name *

Phone *

Email *

Should you currently be self-isolating? *

Are you currently experiencing: Breathing difficulties, chest pain, confusion, loss of consciousness Fever/chills, cough, shortness of breath, decrease of taste or smell, muscle aches/joint pain, extreme tiredness? *

In the last 5 days, have you been identified as a “close contact” of someone who currently has COVID-19? *

In the last 10 days, has someone you live with: been sick with symptoms associated with COVID-19? and/or tested positive for COVID-19 (on a rapid antigen test or PCR test)? *

In the last 14 days, have you travelled outside of Canada? (If you are exempt from federal quarantine requirements due to being fully vaccinated or an essential cross-border worker, select NO) *

Appointment Request

Are you a new or existing client?

New Client

Existing Client