![COVID-19 Patient Screening Questionnaire](https://www.jotform.com/uploads/Dentistontherock/form_files/dda smile studio logo v6 black NO SENILE.5ee8bc25f335a5.73816524.jpg)
COVID-19 Patient Screening Questionnaire
To prevent the spread of COVID-19 and reduce the potential risk of exposure to our staff and patients, we are conducting a simple screening questionnaire. Your participation is important to help us take precautionary measures to protect you and everyone in this building. Thank you for your time.
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