Patient Screening Form
Our communities have been through a lot over the last few months, and all of us are looking forward to resuming our normal habits and routines. While many things have changed, one thing has remained the same: our office’s commitment to your safety.
Infection control has always been a top priority in our practice. We follow recommendations and guidelines made by the American Dental Association (ADA), the Centers for Disease Control and Prevention (CDC), and the Occupational Safety and Health Administration (OSHA). This allows us to make sure that our infection control procedures are up-to-date and enables us to provide the safest environment for our patients and their family members. We ask that you please be patient and understand that we will do our best to accommodate your scheduling needs as we know many of you are anxious to get back into our office. During this time, we have implemented additional safety precautions to help protect our patients and staff.
- Upon scheduling an appointment, a COVID-19 questionnaire will be emailed to you. This questionnaire must be completed before you arrive at the office. We will postpone treatment for any patient who has experienced or been in contact with
someone who has experienced the following symptoms within 14 days of the scheduled appointment date: fever, cough, loss of taste and/or smell, flu-like symptoms, difficulty breathing or shortness of breath, and fatigue.
- If you are over the age of 65 or have preexisting health conditions (as recommended by CDC) such as diabetes, chronic lung disease or asthma, serious heart conditions, are immunocompromised, or chronic kidney or liver disease, we recommend you do not visit the office at this time. If you fall into this category but need to accompany a child or family member for a visit, please call our office as we will handle this request on a case-by-case basis.
- We will be scheduling appointments in a manner that promotes social distancing and allows for adequate time for us to disinfect all areas of use in between patient appointments.
- Upon arrival at our office, call us before entering the office to let us know you have arrived. We will call or text you once the office is ready for you to enter.
- We ask that patients enter the office unaccompanied, if possible. For those patients who need a guardian to accompany them, we ask that this be limited to a single family member.
- Every person entering the office is expected to wear a face covering and will be asked to sanitize their hands immediately upon entry.
- Please take your temperature the morning of your appointment. We will confirm no fever with a contact less thermometer upon your arrival.
- Our waiting room will no longer offer magazines, charging stations, children’s toys, and so forth, since these items are difficult to clean and disinfect.
- Clear plastic screens (sneeze guards) have been installed at the front desk to minimize exposure to airborne pathogens.
- Medical-grade high efficiency particulate arrestance (HEPA) air purifiers have been installed in the office to help improve the air quality in the area for all patients, family members, and staff.
- Our doctor and staff will be wearing all of the recommended personal protective equipment (PPE).
We look forward to seeing you again and are happy to answer any questions you may have about the steps we take to keep you, and every patient, safe in our practice. To make an appointment, please call our office at 925-829-2800 .
Thank you for being our patient. We value your trust and loyalty and look forward to welcoming back our patients, neighbors and friends in the safest way possible.