To find Family Physicians Accepting New Patients click here
Skip to content
Family Medicine|New Patients|Walk-In|Specialists|North York Logo

FAMILY & SPECIALTY MEDICINE & WALK-IN
416-222-6160
2 Champagne Drive: East Entrance
Champagne Centre
Toronto, ON M3J 0K2

  • Home
  • Walk In Clinic
    • Walk-in Clinic
  • Family Medicine
    • Physicians Accepting New Patients
  • Specialty Medicine
    • Specialty Consultation Areas
    • H. Pylori testing
    • Nerve Conduction Studies
    • FibroScan Testing
    • Balance and Dizziness Testing
  • Services
    • Cardiology Department
    • Laboratory and Physician Assistant Services
    • North York Pulmonary Function Centre
    • North York Sleep & Diagnostic Centre
    • Independent Tenants/Subtenants
  • About Us
    • Our Vision
    • Management Team
    • Our Doctors
    • Clinical Research
    • Photo Gallery
  • Resources
    • For Patients
      • Appointment Reminders
      • Polyclinic Notices
      • Polyclinic Policies
      • Patient Instructions
      • Patient Feedback
    • For Physicians
      • Referral Information
      • Referral Forms
      • Physician Feedback
  • Contact
    • Clinic Directory
    • Map & Directions
    • Hours of Operation
    • Facility Map
    • Join our team
  • Home
  • Walk In Clinic
    • Walk-in Clinic
  • Family Medicine
    • Physicians Accepting New Patients
  • Specialty Medicine
    • Specialty Consultation Areas
    • H. Pylori testing
    • Nerve Conduction Studies
    • FibroScan Testing
    • Balance and Dizziness Testing
  • Services
    • Cardiology Department
    • Laboratory and Physician Assistant Services
    • North York Pulmonary Function Centre
    • North York Sleep & Diagnostic Centre
    • Independent Tenants/Subtenants
  • About Us
    • Our Vision
    • Management Team
    • Our Doctors
    • Clinical Research
    • Photo Gallery
  • Resources
    • For Patients
      • Appointment Reminders
      • Polyclinic Notices
      • Polyclinic Policies
      • Patient Instructions
      • Patient Feedback
    • For Physicians
      • Referral Information
      • Referral Forms
      • Physician Feedback
  • Contact
    • Clinic Directory
    • Map & Directions
    • Hours of Operation
    • Facility Map
    • Join our team

COVID-19 Pre-Screening Questionnaire

Home/COVID-19 Pre-Screening Questionnaire

  • COVID-19 PRE-SCREENING QUESTIONNAIRE

  • Please complete our COVID-19 screening 1 – 2 days before your scheduled in-person appointment

  • To help our health professionals with your assessment and as a precaution to limit the risk of transmitting the COVID-19 virus, it is important we take measures to protect our patients, staff and physicians.
  • MM slash DD slash YYYY
  • Kindly answer the below questions before seeing the physician or having your testing done:
  • MM slash DD slash YYYY

  • b) Did you isolate the greater of;

  • If you answer yes to any of the above questions, do not come into the clinic. Call our office to re-schedule your in-person appointment and call Telehealth Ontario at 1-866-797-0000

  • If you have additional questions, please contact Health Connection, Monday to Friday from 8:30 am to 4:30 pm at 1-800-361-5653. After hours please call Telehealth Ontario at 1-866-797-0000.

    October 8, 2020

  • Date of form submission: 05/01/2025

Polyclinic Family and Specialty Medicine located in North York

Family & Specialty Medicine
Walk-in Clinic
2 Champagne Drive
Champagne Centre
Toronto M3J 0K2

Book an Appointment

416 222 6160

9am-8pm Monday-Friday
Saturday 9am-1pm or by appointment
OR visit our walk-in clinic directly

Privacy Overview

This website uses cookies so that we can provide you with the best user experience possible. Cookie information is stored in your browser and performs functions such as recognising you when you return to our website and helping our team to understand which sections of the website you find most interesting and useful.

Strictly Necessary Cookies

Strictly Necessary Cookie should be enabled at all times so that we can save your preferences for cookie settings.

If you disable this cookie, we will not be able to save your preferences. This means that every time you visit this website you will need to enable or disable cookies again.