All patients are to be screened before their appointment AND when they arrive for their appointment.





    PatientOther


    Relationship to Patient*

    A dental team member will contact you and identify themselves and will then explain the purpose of the call before your appointment. The reason for this will be to determine whether there are any special considerations for your dental appointment. Please answer the following questions.


    PhoneEmailOther




    Screening Questions

    Do you have a fever or have felt hot or feverish anytime in the last two weeks?



    YesNo


    YesNo






    YesNo


    YesNo





    YesNo


    YesNo





    YesNo


    YesNo




    YesNo


    YesNo





    YesNo


    YesNo





    YesNo


    YesNo





    YesNo


    YesNo






    Any "Yes" response must be discussed with the managing dentist immediately.

    When you arrive at the office, you will be asked to:

    • Sanitize your hands.
    • Answer the questions again.
    • Have your temperature taken.
    • Complete a form acknowledging the risk of COVID-19.

    Please be advised:

    • Only patients are allowed to come to the office.
    • If possible, please wait in your car until your appointment, and call the office when you arrive to let us know you are waiting nearby.