Dear Valued Patient,
Due to the harsh influenza season this year and the threat of the Corona Virus (COVID-19), please let us know if you’ve had any recent respiratory symptoms and/or if you have traveled inside or outside of the United States within the last month. If you have had any of the following symptoms, traveled as previously stated, or have had direct contact with anyone who has tested positive or currently in quarantine within the last 30 days, we will need to reschedule your appointment to a later date.
Thank you for your cooperation in making sure we protect our patients and our team.
Symptoms to look for:
- Fever
- Malaise
- Headache
- Body Aches
- Shortness of Breath
- Chills
- Cough
By signing below, you are confirming that you have not recently had any of these symptoms AND you have not traveled or been in contact with people infected or quarantined in the last 30 days.