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This form is to be used by people who will be visiting an Anova or Juno location. It should be completed immediately before your appointment.
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This declaration form is a requirement by Public Health Ontario to limit the risk of COVID-19 exposure while providing care. If you have any questions or concerns, please contact us at email@example.com
Location and time of appointment
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I attest that the above statements are true and valid to the best of my knowledge.
We have now reopened and are booking appointments with new COVID-19 protocols in place:
Please call us for more information or to book an appointment