Covid19 Screening Form

Please note that this form is considered part of your confidential health information and is not stored on the website once submitted.

Name*
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Email
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Your Therapist
Have you, or someone in your household recently tested positive for COVID-19?*
- Yes
- No
Do you or the person you are inquiring about have any of the following symptoms: severe difficulty breathing (e.g., struggling for each breath, speaking in single words), chest pain, confusion, extreme drowsiness or loss of consciousness?*
- Yes
- No
Do you have a new onset of any of the following symptoms: fever/chills, cough, sore throat/hoarse voice, shortness of breath, loss of taste or smell, vomiting, or diarrhea for more than 24 hours and if the client is an infant, poor feeding and lethargy?*
- Yes
- No
Have you been instructed or advised to self-isolate or quarantine within the last 7 days due to possible exposure to COVID-19?*
- Yes
- No
Today's Date*
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What’s New

Falls prevention, home accessibility, energy conservation – According to the Canadian Patient Safety Institute, falls are a leading cause of injury among elderly Canadians and are the cause of 85% of hospitalizations of seniors. Apex Therapy Services Occupational Therapists are able to assess all areas of a person’s home to identify potential areas of fall risk and provide energy conservation strategies. There are many interventions and adaptive aids that can be used to allow for greater independence and safety when mobilizing in the home, even for accessing different floors of the home.

Learn about Home accessibility, falls prevention, energy conservation

Virtual ergonomic consultation with a registered OT – Now more than ever, people are working in new environments – very often in the home since moving out of business offices during the pandemic. Unfortunately, these work spaces are usually set up using whatever home furniture is available and very quickly we find out this set up was not intended for long-term use and may in fact be causing pain. Apex Therapy Services now offers ergonomic and workstation consultations virtually to assist with your specific home-office needs!

Learn about virtual workstation assessments