Patient Screening Questions
Do you have a fever or have you felt hot or feverish in the last 14 to 21 days? Yes or No
Are you having shortness of breath or difficulties breathing? Yes or No
Do you have a cough? Yes or No
Do you have any other flu-like symptoms, such as gastrointestinal upset, headache or fatigue? Yes or No
Have you experienced recent loss of taste or smell? Yes or No
Are you in contact with any confirmed COVID-19 positive patients? Yes or No
Patients who are well, but who have a sick family member at home with COVID-19 should postpone elective treatment.
Is your age over 60? Yes or No
Do you have heart disease, lung disease, kidney disease, diabetes or any auto-immune disorders? Yes or No
Have you traveled outside Kansas or Missouri in the past 14 days to any regions affected by COVID-19? Yes or No
Have you traveled to any regions significantly affected by COVID-19 in the last 14 days?
Positive (YES) responses to any of the above questions may result in a deeper discussion with the dentist before proceeding with elective dental treatment.
Are you having shortness of breath or difficulties breathing? Yes or No
Do you have a cough? Yes or No
Do you have any other flu-like symptoms, such as gastrointestinal upset, headache or fatigue? Yes or No
Have you experienced recent loss of taste or smell? Yes or No
Are you in contact with any confirmed COVID-19 positive patients? Yes or No
Patients who are well, but who have a sick family member at home with COVID-19 should postpone elective treatment.
Is your age over 60? Yes or No
Do you have heart disease, lung disease, kidney disease, diabetes or any auto-immune disorders? Yes or No
Have you traveled outside Kansas or Missouri in the past 14 days to any regions affected by COVID-19? Yes or No
Have you traveled to any regions significantly affected by COVID-19 in the last 14 days?
Positive (YES) responses to any of the above questions may result in a deeper discussion with the dentist before proceeding with elective dental treatment.