Clinic COVID-19 Pre-Screening Tool
Re-Active Athletic Therapy requires all potential patients and patients with follow-up appointments (if a minor - parent/guardian attending as well; if requiring support worker/person attending as well) to complete this pre-screening questionnaire in full.
Name (first & last name) *
Email address *
Please confirm email address *
Do you have shortness of breath at rest? *
Do you have difficulty breathing when lying down? *
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