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COVID-19 PANDEMIC DENTAL TREATMENT NOTICE AND
ACKNOWLEDGEMENT OF RISK FORM
At Buckeye Pediatric Dentistry, our goal is to provide a safe environment for our
patients and staff and to advance the safety
We are not affiliated with any brand or entity on this form
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How to fill out dental office covid-19 prescreening
How to fill out dental office covid-19 prescreening
01
To fill out dental office COVID-19 prescreening, follow these steps:
02
Begin by gathering all relevant personal information, such as full name, date of birth, email address, and contact number.
03
Next, carefully read and review the prescreening questionnaire provided by the dental office.
04
Answer each question honestly and accurately by selecting the appropriate response or providing the necessary information.
05
Make sure to disclose any recent travel history or close contact with someone diagnosed with COVID-19.
06
Pay attention to any specific instructions or additional forms required by the dental office.
07
Once you have completed the prescreening questionnaire, double-check all the provided information for any errors.
08
Submit the filled-out prescreening questionnaire using the designated method instructed by the dental office.
09
If you have any concerns or questions about the prescreening process, don't hesitate to contact the dental office for clarification or assistance.
Who needs dental office covid-19 prescreening?
01
Anyone who is planning to visit a dental office needs to complete the dental office COVID-19 prescreening.
02
This applies to both new and existing patients, as well as any accompanying individuals who may be visiting the office.
03
The prescreening is essential to ensure the safety of everyone present and helps in identifying potential COVID-19 risks.
04
By completing the prescreening, patients demonstrate their commitment to maintaining a safe environment for themselves and others at the dental office.
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What is dental office covid-19 prescreening?
Dental office COVID-19 prescreening involves screening patients and staff for COVID-19 symptoms before their appointment.
Who is required to file dental office covid-19 prescreening?
Dental offices are required to conduct and document COVID-19 prescreening for patients and staff.
How to fill out dental office covid-19 prescreening?
Fill out the prescreening form by asking questions about symptoms, recent travel, and potential exposure to COVID-19.
What is the purpose of dental office covid-19 prescreening?
The purpose is to minimize the risk of COVID-19 transmission within the dental office and protect the health of patients and staff.
What information must be reported on dental office covid-19 prescreening?
Information such as symptoms, recent travel, and potential exposure to COVID-19 must be reported on the prescreening form.
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