Covid-19 Declaration

Covid-19 Health Declaration

How are you feeling today?

First Name

Last Name

Email

My body temperature is lower than 37.5°C

I am not experiencing any of the symptoms eg: fever, cough, runny nose, sore throat

I haven’t been in close contact with a Covid-19 patient in the last 14 days

I have not visited a Covid hotspot in the last 14 days

Will 30 days have passed since your last Covid-19 Vaccination to the date of your scheduled appointment? If no, please consider rescheduling

Initials

Date

I declare that the info I’ve provided is accurate & complete

I accept terms & conditions

Thanks for submitting!

Sunday - Monday: Closed

Tuesday - Wednesday - 10am - 10pm

Thursday - 10am - 6pm

Friday - 10am - 10pm

Saturday - 10am - 6pm

All sessions by appointment only

14 Stockade Ave Coburg

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