• Coronavirus -COVID-19 Self Declaration Screening Form

  • For the health and safety of our patients, office staff and community, declaration of illness is required. Be sure that the information you'll give is accurate and complete.

    Unfortunately due to COVID Pandemic  we are no longer provide any “In-office consults”, all consults must be exclusively via phone consults, photos, videos and/or virtual, unless prearranged, thorough screening process, evidence of negatively COVID PCR Tests results within 24hrs and management approval.

     
    We are no longerallowed to have anyone enter the office unless they have a scheduled appt. Pre-approval must be requested if needed due special needs circumstances at time appt is made, proof of negative COVID PCR test results within 24hrs and will be submitted for management approval.


    Thank you for your understanding, cooperation and assistance in ensuring your safety as well as our staff, provider, families and community

    Please seek immediate medical attention if you have any of the COVID-19 signs.

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  • I acknowledge that the information I've given is accurate and complete.

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