Disclosure Form

Covid Positive

RMTs cannot provide treatment until you have been cleared, or your case is considered resolved by a primary care provider, Telehealth, or Public Health (via your local public health unit). You can provide confirmation verbally or in written form.

Have you traveled outside of Canada in the past 14 days?

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 of 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 or nasal congestion without other known cause

If you are 70 years of age or older, are you experiencing any of the following symptoms?

• Delirium
• Unexplained or increased number of falls
• Acute functional decline
• Worsening of chronic conditions

What should I do next?

The Public Health Agency of Canada strongly urges anyone who has any of the following symptoms: fever, cough, sore throat, runny nose, or headache to ISOLATE at home or another suitable location. 

Please quarantine for 14 days if you’ve traveled outside of Canada in the past 14 days before an appointment.

For more information on COVID-19, refer to the Government of Canada COVID-19 website or feel free to contact us at info@sanctuarydayspas.com