50 Westmount Rd N Waterloo, ON N2L 2R5
Ph: 519-954-0111 Fax: 519-954-0112
*For appointments booked using this form, we do not schedule same-day appointments. Once our staff receive your details, they will contact you to confirm your appointment time.
Please note: Electronic message transmission cannot be guaranteed to be secure or error-free, as information could be intercepted, corrupted, lost, destroyed, arrive late or incomplete, or contain viruses. If you prefer, please call our booking line at 1-855-414-2255 with any information containing your personal health information, as the integrity and security of this message cannot be guaranteed on the Internet.
*If you need urgent medical care, please head to your nearest emergency room, or dial 911.
*Phone lines are open Mon-Fri 9AM-8PM, Sat: 9AM-1PM, Sun: Closed.
By submitting this medical intake form, I am acknowledging that all the information is true and correct to the best of my knowledge. Waterloo Walk In Clinic “The Clinic'' and its affiliates aims to deliver your COVID-19 test results within 48-72 hours of your collection appointment however, the traveller is asked to note that this is not a guarantee for the return of your results. The clinic is not responsible for any errors that are present on the test result or any financial implications that may occur in your travel plans as a cause of an error on the test results or a delay in the return of your covid-19 swab results. By submitting this form I hereby acknowledge that I have completely read and understood the Covid-19 travel swab policy guidelines as stated above.