This questionnaire was designed with your safety in mind. Thank you for your consideration and understanding.

Have you tested positive for COVID-19?

Have you been tested for COVID-19 and are awaiting results?

Do you have any of the following respiratory symptoms? Fever, Sore Throat, Cough, Shortness of Breath?

Have you recently lost your sense of smell or taste?

Do you have any GI symptoms? Diarrhea? Nausea?

Even if you don’t currently have any of the above symptoms, have you experienced any of these symptoms in the last 14 days?

Have you been in contact with someone who has tested positive for COVID-19 in the last 14 days?

Have you traveled outside the United States by air or cruise ship in the past 14 days?

Have you traveled within the United States by air, bus or train within the past 14 days?

If you answer yes to any of these questions, your appointment will need to be rescheduled.