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Covid-19 Health Form

SUPPLEMENTAL
HEALTH QUESTIONNAIRE
Orthodontic Treatment in the Era of COVID-19
  • If you have been exposed to a communicable disease, you may spread the disease to the orthodontist, orthodontic staff, or other patients/parents in the practice. Therefore, prior to each appointment, we will be asking the following questions to reduce the chances of transmission:
  • Do you, your child, others accompanying you to today’s appointment or anyone you have recently been in contact with have any of the following symptoms?
  • Date Format: MM slash DD slash YYYY

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Office Hours

  • Monday: 10am - 6:30pm
  • Tuesday: 9am - 5:30pm
  • Wednesday: 8am - 5pm
  • Thursday: 8am - 5pm
  • Friday: Closed
  • Saturday: Once A Month
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