Covid-19 FORM
On your next visit, it will be important to follow the protocol put in place by Public Health and the CNESST: wearing the mask, coughing in your elbow or on your shoulder and hand hygiene.

Wearing a mask or face covering will be required, from the entrance to your departure from your appointment.

***The mask or face covering must be worn by the client receiving the treatment, except for the duration of the treatment that requires its removal.***

By sending this questionnaire, I declare that I have answered to the best of my knowledge. It is my responsibility to advise Mr. Roy of any changes that may occur between the sending of this questionnaire and the date of the appointment.

Thank you for your collaboration!

Roger Roy N.D.

After completing the Covide-19 questionnaire, you will be redirected to my Covid-19 page on my website. I invite you to read the information and instructions. If you have any questions, please write to me.
  • - -
  • Children have been more commonly reported to have abdominal symptoms, and skin changes or rashes.

    In severe cases, infection can lead to death.

    Symptoms may take up to 14 days to appear after exposure to COVID-19.

    Recent evidence indicates that the virus can be transmitted to others from someone who is infected but not showing symptoms. This includes people who:
    - have not yet developed symptoms (pre-symptomatic)
    - never develop symptoms (asymptomatic)

    SOURCE : https://www.canada.ca/en/public-health/services/diseases/2019-novel-coronavirus-infection/symptoms.html#s
Powered byEMF Online Payment Form
Report Abuse