Dave Miseferi, Athletic Therapy & Massage Therapy Dundas, ON

Have you been in close contact with anyone with acute respiratory illness or travelled outside of Ontario in the past 14 days?

Yes

No

Have you had a confirmed case of COVID-19 or had close contact with a confirmed case of COVID-19?

Yes

No

Fever.

Yes

No

New onset of cough.

Yes

No

Worsening chronic cough.

Yes

No

Worsening chronic cough.

Yes

No

Shortness of breath.

Yes

No

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