Covid-19 Health Self-Assessment

We are looking forward to seeing your smile soon!  Out of concerns for our patients, dentist and team members, our office is following the recommendation of the Centers of Disease Control (CDC) to screen patients before making treatment decisions. Please review below questions prior to your appointment. 

If you answered YES to the health self assessment questions, we respectfully ask that you call us.

Covid-19 Health Self - Assessment

1.    Have you, anyone you live with felt feverish in the last couple weeks?

2.    Are you having shortness of breath or other difficulties breathing?

3.    Do you have a cough?

4.    Any other flu-like symptoms, such as GI upset, headache or fatigue?

5.    Have you experienced recent loss of taste or smell?

6.    Have you been in contact with someone who has tested positive for COVID-19?

*Patients who are well but who have a sick family at home with COVID-19 should consider postponing elective treatment*

7.   Have you recently traveled to states currently designated as COVID-19 "hotspots"?

8.   Have you been tested for COVID-19 and are awaiting results?

9.   Recently, were you medically quarantine?


Positive responses to any of these will indicate a deeper discussion with the dentist before proceeding with elective dental treatment.


Adopted from the American Dental Association (ADA).  

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