• Patient Screening - Covid-19

  • Use this form to screen patients before their appointment and when they arrive for their appointment.



  • Identify yourself and explain the purpose of the call, which is to determine whether there are any special considerations for their dental appointment. Have the patient answer the following questions.

  • Screening Questions( Pre-Screen)



  • Screening Questions( In-Office)



  • form_phipa

  • Should be Empty: