COVID-19 Questionnaire & Informed Consent – General

COVID-19 Questionnaire and Informed Consent to Treatment during the COVID-19 Outbreak

As Corona Virus Disease 2019 (COVID-19) continues to spread, the safety of our patients, staff members, and visitors to La Fontaine Source De Jeunesse remains our overriding priority. As a result, only patients with scheduled procedures and designated staff members are permitted at the Premises. To protect you and everyone at the Premises, we are conducting a simple screening questionnaire and COVID-19 test to determine your access rights to the Premises. Any questions regarding this should be directed to Dr. Chameli Deb, the Medical Director. An infection is one of the post-operative complications that can occur, and during these unprecedented times, COVID-19 can be a risk. To limit this risk, we implement practices based on current recommendations from the Ontario Ministry of Health, such as our staff using recommended personal protection equipment (PPE) and following disinfection protocols.

COVID-19 Screening Questionnaire

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