Receiving Dental Treatment During the COVID-19 Pandemic
You have presented to the office today because you have an urgent dental condition which must be treated at this time and cannot be postponed until the current COVID-19 risk period abates. Please be advised of the following:
In order to reduce the risk of spreading COVID 19, we have asked you a number of “screening” questions below. For the safety of our staff, other patients, and yourself, please be truthful and candid in your answers.
PLEASE ANSWER “YES” OR “NO” ALONG WITH YOUR INITIALS, TO THE FOLLOWING QUESTIONS:
Your information will be encrypted.