EXPERT SPORT MEDICINE CARE
↑ SPORT MED NORTH
Check List for Patients to Complete Prior to Their In-Office Appointment With Dr. Carson
Have you or anyone you have had close contact with travelled outside of Ontario in the past 14 days?
Have you been confirmed or had close contact with someone who has been confirmed with a case of COVID-19?
Do you have any of the following symptoms?
New onset of cough
Worsening chronic cough
Shortness of breath
Decrease or loss of sense of taste or smell
Unexplained fatigue/ muscle aches
Nausea / Vomiting, diarrhea, abdominal pain
Runny Nose/ Nasal congestion without other known cause
If you are 70 years of age or older
Are you experiencing any of these additional symptoms?
Unexplained or increased number of falls
Acute functional decline
Worsening of chronic conditions
Please answer these questions truthfully as we are trying to protect all of our patients, staff, and doctors! Failure to do so will result in serious consequences