Upon arrival

For patients safety and to manage physical distancing, our front door remains locked. When you arrive, please call us at 613 521 3939 to let us know that you’ve arrived for your appointment, someone will come and meet you at the door.

Mask Mandatory

Your safety is our priority and thank you in advance for your cooperation. If you have any questions, please do not hesitate to contact us.

Call 613-521-3939 or email

Please be advised that when you arrive for your appointment, we will take your temperature and ask quick screening questions. Please call us when you arrive for your appointment. Your safety is our first priority.

Do you have any of the following symptoms?:

  • Fever
  • New onset of cough
  • Worsening chronic cough
  • Shortness of breath
  • Difficulty breathing
  • Sore throat
  • Difficulty swallowing
  • Decrease or loss of sense of taste or smell
  • Chills
  • Headaches
  • Unexplained fatigue/malaise/muscle aches (myalgias)
  • Nausea/vomiting, diarrhea, abdominal pain
  • Pink eye (conjunctivitis)
  • Runny nose/nasal congestion without other known cause
    Please read the patient acknowledgement below, and initial or sign in all areas indicated.
    ( Initial )
    ( Initial )
    ( Initial )
    ( Initial )
    ( Initial )
    ( Initial )
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    ( Initial )
    I verify the information | have provided on this form is truthful and complete. | knowingly and willingly consent to have emergency surgical/dental treatment completed during the COVID-19 pandemic.