COVID-19 Patient Screening

Please answer the following questions to ensure you are COVID-19 symptom free.

Patient Name *

Date *

It is important to closely monitor your health and the health of those you care for to help prevent the spread of COVID-19 and other illnesses like the flu.

1. Do You Feel Sick? *

Yes

2. In the past 48 hours, have you had, or are you currently experiencing;

Cough (New or Worsening) *

Yes

OR two or more of the following symptoms (new or worsening);

Fever (i.e. chills/sweats) *

Yes

Sore Throat *

Yes

Runny nose/nasal congestion *

Yes

Headache *

Yes

If yes, go home or stay home as noted above. Follow Public Health instructions for testing and isolation.

3. Have you recently visited a COVID-19 exposure site? *

Yes

4. Have you travelled in the past 14 days outside of the province and/or country AND been advised to self-isolate? *

Yes

Spam Blocker

At Family Dental Care in Prince George and Vancouver, our passion is oral health. Our dentists, specialists and dental team are committed to helping you maintain your smile and your overall health.
- The Family Dental Care Team

New Patients Always Welcome

Looking for a dentist in British Columbia? We're happily accepting new patients! Contact a Prince George or Vancouver location near you.

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We are a proud member of
the network.

Locations

College Heights
Downtown
River Point
Spruceland
Specialty Clinic
Vancouver

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