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COVID-19 Health Screening
Please complete a separate COVID-19 health screening for each person in your family entering Treasured Smiles Pediatric Dentistry today. Spanish form available here (Formulario en Espanol aqui)
Do you/they have a fever or have you/they felt hot or feverish in the last 14 days?
Are you/they having shortness of breath or other breathing difficulties?
Do you/they have a cough?
Do you/they have flu-like symptons, such as gastrointestinal upset, headache, or fatigue?
Have you/they experienced recent loss of taste or smell?
Are you/they in contact with any confirmed COVID-19 postitive patients?
Do you/they have heart disease, lung disease, kidney disease, diabetes or any Auto-immune disorders?
Have you/they traveled within the US or to any foreign country within the last 14 days?

Thanks for submitting! Any positive responses to any of these would require a deeper discussion with Dr. De La Cruz. Please contact us to discuss before proceeding with your appointment.

Positive responses to any of these would likely indicate a deeper discussion with Dr. De L Cruz before proceeding with elective dental treament
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