Acuity Counselling & Therapy
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COVID-19 Screening and Consent to Receive In-person Services

​Thank you for your patience and understanding during closure of our premises in compliance with the directives from the Premier and Dr. Strang during the COVID-19 pandemic. For all of our safety, please fill out this form prior to each therapy session (until further notice). Be sure that the information given is accurate. Thank you for your understanding and cooperation during this unprecedented time.
    ​The following are a list of COVID-19 symptoms:
    • Fever (i.e. chills, sweats)
    • Cough or worsening of a previous cough
    • Sore throat
    • Headache
    • Shortness of breath
    • Muscle aches
    • Sneezing
    • Nasal Congestion/runny nose
    • Hoarse voice
    • Diarrhea
    • Unusual fatigue
    • Loss of sense of smell or taste
    • Red, purple or blueish lesions, on the feet, toes or fingers without clear cause
    *If you answered YES to any of the above questions, you will be asked to reschedule your appointment for another day. No cancellation fee will be applied, in this case. Thank you for understanding.*

    Please make sure you have carefully read and understood the following before submitting this form.

SUBMIT
LOCATION
​3400 Dutch Village Road, Suite 101
Halifax, NS, B3N 0E7

CONTACT INFO
​Phone: 902.406.3400
Fax: 902.406.4775
​Email: info@acuitytherapy.ca
BOOK AN APPOINTMENT today
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HOURS OF OPERATION
Our therapists have varying schedules. We operate Monday to Friday from 9am to 7pm. We offer daytime and evening appointments.

LICENSING BODIES
The Nova Scotia Board of Examiners in Psychology
Nova Scotia College of Social Workers

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