• COVID Questionnaire

    COVID Questionnaire

    If you have been exposed to a communicable disease, you may spread the disease to the orthodontist, orthodontic staff, or other patients/parents in the practice. Therefore, prior to each appointment, we will be asking the following questions to reduce the chances of transmission:
  • Do you, your child, or others accompanying you to today’s appointment or other recent acquaintances have:

  • Signature

  • I understand that if the answer to any of these questions is yes, I will be asked to reschedule today’s orthodontic appointment.

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