COVID-19 Screening Form
We, at Clinton Dental Clinic, are required to ask COVID-19 screening questions in advance of your appointment.
If you answer YES to any of the following questions, please contact our office 519-482-9392.
1) Have you tested positive for COVID in the last 10 days?
2) Have you been in close contact with a confirmed case of COVID in the last 10 days without wearing PPE?
3) Have you or anyone in your household been instructed to self-isolate?
4) Do you have ANY of the following cold, flu or COVID symptoms:
* Onset of new cough
* Difficulty breathing
* Sore or scratchy throat
* Runny nose/nasal congestion not related to allergies
* Nausea, vomiting, diarrhea
Arrive to your appointment only a few minutes early for screening.
We look forward to seeing you at your dental visit and brightening your smile.