In order to ensure your protection, that of the medical and nursing staff but also of the other patients present on our premises, we have set up specific Covid crisis protection and safety measures adapted to this particular context. This upsets our habits and those of our visitors.
The Covid risk self-assessment survey that we ask you to fill in on-line is an important step in this process, so we ask you to give the greatest attention to it.
This questionnaire is to be filled in by you before you come to any of our premises as well as by any person who will accompany you (up to a maximum of 1 additional person)
Please access the self-assessment only if you intend to carry it out in full.
Remember once the assessment is complete to:
You will be asked for it at your reception.
Your self-assessment is uniquely identified via a code indicated in the report. This code is KEY as it allows you to retrieve the results of the questionnaire that you will have printed before coming for your scheduled visit.
If you have not been able to print this document, or if you have lost it, only this identifier will allow us to find the results of your self-assessment, which is essential for your entry into the institution.
So please keep it safe. It is at the top of the report that you receive by email before you print it, you can also take a screenshot from your computer or smartphone. You can copy it and keep it with your other documents (health card, health insurance certificate, ...).
If you forget or lose this identifier, it is not possible to find the result of your self-assessment and will have to be redone when you come.
Before you came to our hospital:
Please ensure you complete this self a fairly short time before you come (D-2), in order to have the most up-to-date information possible, particularly with regard to any symptoms that may have appeared since your last consultation.
Ideally, on the evening two days before your scheduled visit you should take this assessment. That will give you time to discuss with your referring doctor or our teams in case of new or unusual elements. In case of planned hospitalization, you will be contacted the day before (D-1) and you will be able to indicate at this time the result of the evaluation, which will allow us to adapt the treatment offered to you if necessary. During this call, you will receive useful information for your arrival and answers to the questions you have.
At any time
You can use this self-assessment questionnaire at any time if you have any doubts, or if unusual symptoms appear. Depending on the orientations that will be proposed to you at the end of the evaluation, you may contact your referring doctor at the clinic and/or your attending physician to inform them of these new elements.
First of all, it is important that anyone who needs to seek treatment can do so safely and without delay. The period of confinement has imposed constraints on the distancing necessary to block the spread of the virus, but has also postponed necessary medical treatment that must now be provided without further delay.
Our country is entering a delicate phase of de-confinement, which imposes on all of us an increased vigilance and some necessary constraints without neglecting your state of health. This self-assessment questionnaire is part of this vigilance and will allow us to evaluate the risk that you have encountered the virus with possible consequences for your health and that of your loved ones.
Whatever the result, it will enable us to offer you a treatment adapted to the risk of Covid, by ensuring the continuity of care necessary and justified by your state of health. In certain situations, it will be advised to you before your arrival, to contact your doctor, the one who follows you in the establishment or your general practitioner, in order to propose a new consultation in the surgery or in tele-consultation to adapt the care to your situation of the moment.
The information entered in this questionnaire is anonymous. It is personal and only you are able to entrust it to a health professional authorised to access it in accordance with the regulations concerning data protection, particularly health data.
Vivalto Santé is required to collect information on your state of health in the context of the fight against and prevention of the spread of the Covid-19 epidemic. This information is kept for the duration of the Covid crisis or failing that for a period of 1 year in anonymous form and will not be communicated to a third party.
Your data are only recorded if you fill in the form to the end, your answers are sent to a server and remain anonymous: your IP address is not collected. Your e-mail address for sending the evaluation result is dissociated from the evaluation and is not stored.
Exercising your rights
For any information or to exercise your rights to information technology and freedom regarding the processing of personal data managed by an establishment of the Vivalto santé group, you can contact the management of the establishment or the Data Protection Officer (DPO) by email: dpd@vivalto-sante.com.
In the event of difficulties, you can also file a complaint with the Commission Nationale de l'Informatique et des Libertés (CNIL).
Vivalto Santé – Entre nous la vie