This screening form should be used twice; once during pre-screening (e.g. over the phone when confirming theappointment), and a second time when the patient presents at the office for their appointment. Answers tothese questions must be documented in the patient record.
2. Do you have or recently had (14-21 days) any of the following symptoms:
“YES” responses to any of these questions would indicate the need for a deeper discussion with the dentistbefore proceeding with treatment. Whenever possible, patients with one or more risk factors should berescheduled to a later date.
Royal Centre Dental Group
1055 W Georgia St #210, Vancouver, BC V6E 3P1
Monday 7:30am-5:00pm Tuesday 7:30am-6:00pm Wednesday 7:30am-8:00pm Thursday 7:30am-8:00pm Friday 7:30am-5:00pm Saturday 8:00am-5:00pm
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