1. Are you experiencing any of the following:
2. Are you experiencing any of the following:
3. Are you experiencing any of the following:
4. Have you travelled to any country within the last 14 days?
5. Have you had close contact with a person with COVID-19 (probable or confirmed) while they were ill (cough, fever, sneezing, or sore throat)?
6. Are you a health care worker?
7. Do you have having underlying chronic condition including diabetes mellitus, hypertension, chronic heart disease, chronic kidney disease, liver disease or a malignancy (cancer), asthma, emphesema or other lung disease
Thank you for filling our appointment request form.
Please look out for an enrollment form from our EMR AtlasMD for our intake forms.
Kindly complete all the necessary information to help expedite your appointment.