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COVID-19 Screening Questions

COVID-19 Screening Questions

 

COVID-19 Screening Questions for Parent/Guardian and Child

If you have any YES answers, please call our office prior to arriving to your appointment

  • Are you currently awaiting the results of a COVID-19 test?

  • Do you/they have fever or have you/they felt hot or feverish recently
    (14-21 days)?

  • Are you/they having shortness of breath or other difficulties breathing?

  • Do you/they have a cough, runny nose, and/or sore throat?

  • Any other flu-like symptoms, such as gastrointestinal upset, headache or fatigue?

  • Do you have sneezing, watery eyes, and/or sinus pain/pressure that is unusual and not related to seasonal allergies?

  • Have you/they experienced recent loss of taste or smell?

  • Are you/they in contact with any confirmed COVID-19 positive patients? 

  • Do you/they have heart disease, lung disease, kidney disease,
    diabetes or any auto-immune disorders?

  • Have you/they traveled in the past 14 days within the United Sates or to any foreign country affected by COVID-19? 

    If so, where?