Respiratory Illness Signs & Screening Form

Please answer YES or NO to the following questions:

Please contact us with questions regarding our COVID-19 precautions.
Directions for your visit:
*Parent(s) and scheduled patient(s) MUST arrive to your scheduled visit wearing a face mask.  
 *Our practice maintains strict social distancing at all times. 
*Temperatures will be taken for ALL patients prior to their reserved time. (Temperature above 100.4 will be rescheduled to a later date.)
*If you or a family member require a weighted blanket for your visit, please bring your own.  We are unable to properly disenfect cloth blankets at this time.