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.
Do you have any of the following symptoms:
Any “yes” response must be discussed with the managing dentist immediately.
Tell the patient when they arrive at the office, they will be asked to:
Advise the patient:
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