COVID-19 Assessment – Dr Ngaka MC Masemola

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Not feeling Very well?

Do not worry you are in safe hands. Kindly fill in the assessment form below.

COVID-19 Assessment 2021

Do you have any of the following symptoms?

Sore throat?
YesNo

Do you have a fever?
YesNo

Are you coughing?
YesNo

Do you have a loss of smell or taste?
YesNo

Do you have chills?
YesNo

Do you have shortness of breath?
YesNo

Does your body ache?
YesNo

Vomiting, diarrhoea and nausea?
YesNo

Fatigue or weakness?
YesNo

Your name

Your email

Temperature

Date

Your Preference
Microsoft TeamsZoom

Your message (optional)

Dr Ngaka MC Masemola Inc

Is committed to provide accessible high quality medical care for people of all ages. Also to promote the health and well being of the local population. We therefore aim to provide services that will exceed the expectation of all our patients.

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Dr MC Masemola

If you have any questions or need help, feel free to contact me for medical assistance.

+27 10 010 6327

+27 68 055 9685

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