COVID-19 questionnaire | Dental Specialists of New York | Orthodontics and Dentistry in NYC | Three Central Locations

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Orthodontic and Dental Treatment in the era of COVID-19

If you have been exposed to a communicable disease, you may spread the disease to the orthodontist/dentist, staff, or other patients/parents in the practice. Therefore, prior to each appointment, we will be asking the following questions to reduce the chances of transmission:

Do you, your child, others accompanying you to today's appointment or anyone you have recently been in contact with have any of the following symptoms?

 
Yes No
Yes No
Yes No
Yes No
Yes No
I understand that if the answer to any of these questions is yes, I may be asked to reschedule today’s orthodontic appointment to a later date.*
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