COVID-19 Screening


    Note: Personal information is being collected by Kemptville District Hospital for COVID-19 screening purposes.
    Required fields are indicated with an asterisk (*)

    Personal information








    Please answer Yes or No to each of the following






    • If you answered No to the previous question, KDH strongly recommends that you have a COVID-19 PCR test up to 72 hours before your surgery. You can go to your local testing facility and state that you are having surgery and need a test. On the day of your surgery, you will be asked to attest that you have had a COVID test and/or to sign a waiver.