COVID-19 Screening Form
For the health and safety of all our patients, your visit to Backhus Family Dentistry will include a temperature reading and the following important screening questions.
- Have you had a fever within the last 14-21 days?
- Are you having shortness of breath or difficulty breathing?
- Do you have a cough?
- Have you experienced a recent loss of taste or smell?
- Have you been in contact with any confirmed COVID-19 positive patients?