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William S. Neale, BA, DDS, MS Date:___ 2021COVID19 SCREENING Questionaire for: ___ first name,last namePlease help us keep everyone safe by completing this initial screening form.PreAppointmentInOfficeDo
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Start by reading the instructions on the covid-19 screening questionaire.
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Fill out personal information such as name, age, and contact details.
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Answer all the questions honestly and to the best of your knowledge.
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If you are experiencing any symptoms related to covid-19, make sure to provide detailed information.
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Who needs covid-19 screening questionaire for?

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Anyone who is required to undergo covid-19 testing as part of a health screening protocol.
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Individuals who are experiencing symptoms of covid-19
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People who have been in close contact with someone who has tested positive for covid-19
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Travelers entering certain countries or regions may also be required to fill out a covid-19 screening questionaire.
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The COVID-19 screening questionnaire is designed to assess an individual's exposure risk and symptoms related to COVID-19 in order to determine the need for testing or quarantine.
Individuals visiting certain facilities, employees returning to work, or anyone entering a specific location that mandates health screenings may be required to fill out the COVID-19 screening questionnaire.
To fill out the COVID-19 screening questionnaire, individuals should provide accurate responses to the questions regarding their health status, recent exposure to COVID-19 positive individuals, and any applicable symptoms they may be experiencing.
The purpose of the COVID-19 screening questionnaire is to identify individuals who may pose a risk of spreading the virus and to help prevent outbreaks by facilitating early detection of potential cases.
The information typically required includes personal identification details, travel history, exposure to confirmed COVID-19 cases, and any current symptoms related to the virus.
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