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GENERAL
ALRC SERVICES AVAILABLE
PRE-ARRIVAL
ARRIVAL & PREPARATION
DURING TREATMENT
POST-TREATMENT
As a patient of ALRC, I have read and understood the “COVID-19 Regulations” stated above. I will also stay updated and adhere to ALRC’s policies as the year progresses.
By completing and signing this declaration form, you agree to the following:
I hereby declare that neither I nor anyone in my household has experienced any cold or flu-like symptoms in the last 14 days (including not limited to; fever, cough, sore throat, respiratory illness, difficulty breathing, or stomach cramps). If I or anyone in my household has experienced any cold or flu-like symptoms after submitting this declaration, I will then not come for treatment at ALRC for a minimum period of 14 days after the cold or flu-like symptoms have subsided. This declaration will remain in effect until ALRC declares that the requirements in this declaration are no longer in effect.
I hereby declare that I or any member of my household have not traveled to or had any lay-over in any country outside Canada in the past 14 days. If I or anyone in my household travel to any country outside Canada after submitting this declaration, I will then not visit ALRC for a minimum period of 14 days after the date of return to Canada. This agreement will remain in effect until ALRC declares the requirements in this declaration no longer in effect.
As a patient of ALRC, I have read and understood the “COVID-19 Declaration and Risk Acceptance” stated above.