COVID-19 Questionnaire

Answer the questions below based on yourself and all persons joining you in your appointment. 

Have you travelled in the past 14 days outside of Canada?
Are you (or anyone in your party) currently experiencing a new cough or one of the following symptoms: fever greater than 38 C, difficulty breathing, muscle aches, exhaustion?
Have you had direct contact with someone diagnosed with COVID-19?

If you have answered YES to any of the above questions, you cannot come to the Novia Mia Red Deer Store. Please re-book in 14-days.

By hitting submit on this form, you certify that the information given in this questionnaire is true and correct for all parties joining you in your appointment. 

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