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For Office Use Only Screening #s P / F / S SDF Urgent EO: 3___14___19___30___Dental Consent Form 20212022 Community Health Center of Southeast Kansas will be providing dental treatment at your children
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How to fill out dental office covid-19 prescreening

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How to fill out dental office covid-19 prescreening

01
Obtain prescreening form from the dental office or their website.
02
Read and understand the questions on the form regarding COVID-19 symptoms and exposure.
03
Fill out the form honestly and accurately, providing all necessary information.
04
Submit the completed form to the dental office prior to your appointment.

Who needs dental office covid-19 prescreening?

01
Anyone who has an upcoming appointment at a dental office.
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Dental office covid-19 prescreening is a procedure to assess the health status of individuals before they enter the dental office to prevent the spread of COVID-19.
All individuals visiting the dental office are required to undergo and fill out the covid-19 prescreening.
Dental office covid-19 prescreening can be filled out by answering questions related to COVID-19 symptoms, recent travel history, and possible exposure to the virus.
The purpose of dental office covid-19 prescreening is to identify individuals who may have COVID-19 symptoms or have been exposed to the virus before they enter the dental office.
Information such as COVID-19 symptoms, recent travel history, and possible exposure to the virus must be reported on dental office covid-19 prescreening.
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