Pre-Appointment COVID-19 Patient Screening
C-Dental has always provided safe, clean and OSHA Compliant imaging centers. With these new COVID19 developments we have enhanced our protocols to be compliant with the new guidelines. Please take the time to fill out this screening questionnaire before attending your appointment at our imaging centers. Your answers will determine if we can confirm your appointment or if it will need to be rescheduled.
Email address *
Patient Name *
Your answer
Which imaging center is your appointment scheduled at? *
Required
Date of Appointment
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Have you or any of your close contacts tested positive for COVID-19?
If you answer YES to this question, we cannot proceed with your appointment at this time and we will notify your referring dentist. The dentist may or may not advise you to see your primary care physician.
Have you or any of your close contacts experienced signs of acute respiratory illness cough, shortness of breath, unexplained fever (≥100.4º F), chills, repeated shaking with chills, muscle pain, headache, sore throat, and/or new loss of taste or smell within the last 3 weeks?
If you answer YES to this question, we cannot proceed with your appointment at this time and we will notify your referring dentist. The dentist may or may not advise you to see your primary care physician.
Have you been in close contact with a person diagnosed with COVID-19?
If you answer YES to this question, we cannot proceed with your appointment at this time and we will notify your referring dentist. The dentist may or may not advise you to see your primary care physician.
Have you or any of your close contacts traveled to New York, New Jersey, Florida, or out of the country in the past 14 days?
If you answer YES to this question, we cannot proceed with your appointment at this time and we will notify your referring dentist. The dentist may or may not advise you to see your primary care physician.
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