PRE-APPOINTMENT SCREENING

Download & Print Patient Screening Form

Scheduling will be asked to schedule a patient out 2 weeks if they answer yes to any of the following questions.  If the patient is emergent – please get in touch with Pamm/Amber as to when would be the best time to see them, so they have minimum contact with staff/patients/families. 

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If patients answer yes at the front desk to two or more, please consult with Pamm/Amber/Doctor about how to proceed. 

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Please schedule out 2 weeks if patients answer yes to the following questions. (10 working days)

Has anyone in your household tested positive for COVID within the last 30 days?
Has anyone in your household cared for an individual who is in quarantine or has a presumptive positive?
Have you or anyone in your household had any of the following symptoms in the last 10 days?
Do you have any reason to believe you or anyone in your household has been exposed to or acquired COVID-19 within the last 10 days?
To the best of your knowledge, have you been near any individual who tested positive for COVID-19 within the last 10 days?

Thanks for submitting!