• Screening form COVID 19

    Screening form COVID 19

    For the health and safety of our community, declaration of illness is required. Be sure that the information you'll give is accurate and complete. Please get immediate medical attention if you have any of the COVID-19 symptoms.
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  • For situations in which isolation is required, see the"When should you isolate yourself (COVID-19)" section of the Quebec.ca website

  • If you answered NO to all the questions: STATUS NOT AT RISK

     

     If you answered YES to at least one of the 2 questions: SUSPECTED/CONFIRMED STATUS.

    Consult with the dental professional before confirming the appointment

  • I acknowledge that the information I've given is accurate and complete.

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  • Should be Empty: