Note: Personal information is being collected by Kemptville District Hospital for COVID-19 screening purposes.
Required fields are indicated with an asterisk (*)
First Name *
Last Name *
Email Address *
Date of Birth *
Surgery Date
Surgeon *
Have you travelled outside of Canada in the last 14 days? * ---YesNo
In the last 10 days, have you been diagnosed with COVID-19? * ---YesNo
In the last 10 days, have you had close contact with a confirmed case of COVID-19? * ---YesNo
Do you have any of the following potential signs or symptoms of COVID-19:
Fever or chills? * ---YesNo
New cough, worsening chronic cough, shortness of breath or difficulty breathing? * ---YesNo
Decrease or loss of smell or taste? * ---YesNo
Unexplained fatigue/malaise/muscle aches (myalgia) or lethargy? * ---YesNo
Nausea, vomiting, diarrhea or abdominal pain? * ---YesNo
Have you recently been diagnosed with pneumonia? * ---YesNo
Have you been diagnosed with unexplained tachycardia, decreased blood pressure or hypoxia? * ---YesNo
Are you having a Colonoscopy or gastroscopy procedure? * ---YesNo
Are you fully vaccinated with a Health Canada approved vaccine? (fully vaccinated: two doses of Health Canada approved vaccine greater than 14 days ago; approved vaccines: Pfizer, Moderna, Astra Zeneca, Johnson & Johnson) * ---YesNo
Please check this box to acknowledge that you have read this information.
KDH maintains masking mandate
KDH volunteers return with the Grand Reopening of their Gift Shop and Coffee Bar
KDH Historical Display at The History Hub in downtown Kemptville will mark Nursing Week
In honour of Nursing Week: Four KDH Nurses who “Answered the Call”
KDH and surrounding hospitals experiencing increased pressures on EDs and ambulance offload processes
KDH receives official designation as a CT Site
KDH celebrates its Volunteers During National Volunteer Week 2022
KDH Board seeking new Directors
KDH names Brittany Rivard as its new CFO and VP Operations
North Grenville COVID-19 Assessment Centre transitioning to DIY Collection Centre
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