• COVID-19 Screening Questionnaire

  • If you experience any symptoms or answer “YES” to any of these questions, please cancel your appointment and contact your health care professional for recommended next steps.

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  • If you answered “Yes” to any part of question two, please reschedule your appointment. You should self quarantine for at least 14 days.

    I certify to the best of my knowledge; this information is accurate.

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