Fill out the Covid-19 Questionnaire

Covid Questionnaire
Do you have fever above 100.4 F *
Are you experiencing any of the following symptoms
A cough *
Shortness of breath *
Loss of taste of smell *
Any flu like symptoms such as upset stomach, headache, fatigue or pains *
Have you been in contact with someone who has tested positive for Covid-19 in the last 14 days *
Have you been tested for Covid-19 in last 14 days *
What is the result of the testing *
Have you travelled anywhere during the last 14 days? *
If Yes, you have to be in quarantine for 14 days before you can come to your appointment
Are you over 60? *
Do you have any heart disease, lung disease, kidney disease, diabetes or any other auto immune disease? *

CORONAVIRUS HEALTH UPDATE
We are now open for all appointments and accepting appointments for new and existing patients. We have implemented additional infection control guidelines in addition to our already stringent OSHA & CDC requirements. Please do not hesitate to call us if you have any questions or concerns. Thank you.