Covid-19 Prescreening

Due to novel Coronavirus, COVID-19 outbreak, we are taking extra precautions with the intake of each client, healthy history review, as well as increased sanitation and disinfecting practices.

Symptoms of COVID-19 include:

Dry Cough
Sore Throat
Sneezing
Skin Rashes
Sudden loss of taste & smell

Fever
Chills
Diarrhea
Vomiting
Difficulty Breathing

Please complete the following pre-screening form below

Your submission is your acceptance that you understand the above symptoms, and have completed the information accurately to the best of your ability.

Name

First Name

Last Name

Have you, or any of your household members:

Symptoms of COVID-19 includes: Fever Chills Diarrhea Vomiting Sneezing Skin Rashes Dry Cough Sore Throat Difficulty Breathing Sudden loss of taste and smell

Experienced any of the symptoms listed above in the last 10 days?

Yes

Been Diagnosed with COVID-19 within the last 10 days?

Yes

Been Exposed to anyone diagnosed with COVID-19 in the past 10 days?

Yes

Travelled outside of the country in the past 14 days?

Yes

If you or anyone from your household members have any of the symptoms listed above in the last 14 days, please contact us to reschedule your appointment.

Covid-19 Prescreening

Symptoms of COVID-19 include:

Please complete the following pre-screening form below

Kinga’s Organic Medi Spa

Our Organic Medi Spa serving Kitchener, Ontario
for Spa, MediSpa and Laser Services

Covid-19 Prescreening

Symptoms of COVID-19 include:

Please complete the following pre-screening form below

Kinga’s Organic Medi Spa

Our Organic Medi Spa serving Kitchener, Ontario for Spa, MediSpa and Laser Services

Our Organic Medi Spa serving Kitchener, Ontario
for Spa, MediSpa and Laser Services