COVID19

Pre-Appointment COVID-19 Screening and Arrival Instructions

You must complete and submit this screening questionnaire BEFORE your appointment. Note: we will ask these same questions at the start of your appointment.

Only essential people (e.g translator, advocate) should attend the appointment with you; they must also complete the screening questions separately.

Arrival Instructions:

Arrive as close to your appointment time as possible.
Medical masks are no longer required in common areas of private dental clinics.
Sanitize your hands on arrival.
Be respectful and kind in consideration others' situations and personal choices.

* Indicates required field

Name *

First

Last

Email *

Phone Number *

Are you experiencing cold, flu or COVID-19-like symptoms, even mild ones? *

Are you under self-isolation or quarantine orders? *

Click button ONCE to submit (it might take a few seconds to see the confirmation message).

Submit