Patient Pre-Appointment Screening
To protect the health and wellness of everyone, please fill-out and submit the below questionnaire for each patient prior to your appointment.
Positive responses to any of these questions will likely indicate a deeper discussion with the dentist before proceeding with elective dental treatment.
*For COVID-19 testing, see the list of State and Territorial Health Department Websites for your specific area's information.
Due to the high cost of Personal Protective Equipment a $10 fee will be applied to all patients. If you have insurance this fee will be submitted to your insurance company.
NOTICE: Face coverings/masks are currently required. Please bring a face covering with you to your appointment.