L &A Hospital Covid Assessment Center Staff Booking

Staff and household members can now be tested at any time 365 days a year with our new self-swabbing process

Answer the question below to register
Pick up the swabbing kit and instruction sheet at the staff self-screening main entrance but please do not SWAB in hospital (take it home or to your vehicle)
Return the swab in the sealed bag in the locked box in that same entrance. Please ensure the tube has the following Full Name/Date of Birth/Time and date you did the swab. 
Without this information the swab cannot be processed
**If you have a positive Covid Rapid test, you do not require to book a PCR test**

Remember to advise Employee Health if you have symptoms or if there is any reason you cannot do your own self-swabbing.
If you fail screening please do not come to work
The earlier you submit your swab the earlier you will have your results. If you drop it off after 3pm you likely will not have results until the following evening

If you have any COVID related questions you can also consult the website below

Covid-19.Ontario.ca
 

1. Swab test date:

   DD/MM/YYYY 
 
 

2. Name of person needing test (first and last name as displayed on healthcard): *

 

3. Are you a staff member? *

 

4. If you answered N, please identify the staff member in your household.

 

5. Health Card # with version code (nnnnnnnnnn-aa): *

 

6. Date of Birth: *

   DD/MM/YYYY 
 
 

7. Preferred contact phone number: *

 

8. Your address (include postal code): *

 

9. Family Dr/Nurse Practitioner and location: (ex: Dr Gary Smith, Napanee) *

 

10. Preferred email or phone # to be used for contact and appointment confirmation:

 

11. Have you had a covid swab before? *

 

12. Have you received the Covid-19 vaccination? *

 

13. Do you have one of the following symptoms? *

 

14. Have you travelled outside of Canada in the past 14 days?

 

15. Have you been in close contact with a confirmed/probable case of Covid-19 in the last 10 days? *

 

16. Have you been notified through the Covid Alert App that you have come in close contact with a positive Covid case in the last 10 days?” *

 

17. Any other information we should know to book your appointment?

 
We are committed to respecting your privacy rights as a guest to the LACGH Covid Assessment Centre Registration Form.
 
Our practices are consistent with Ontario’s privacy legislation.  When you use this form, we collect only what is necessary to provide the health care needed for booking a COVID test.  We take the necessary precautions to protect it from unauthorized access, linkage, disclosure or alteration.
 
For questions or comments regarding this privacy statement, please reach out privacy@lacgh.napanee.on.ca