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COVID-19 Screening FormSchedule Virtual Consultation

COVID-19 Screening Form

As you know, COVID-19 continues to evolve and it’s important for dental clinics to take the necessary precautions in order to stop the spread. With that said, we are conducting active screening for potential risks of COVID-19 with everyone entering our dental office, to ensure the safety and well being of everyone

Please answer the following questions - all fields are required

Your temperature will be taken by one of our team members once you enter our office. If your temperature is 37.8° C (100° F), your appointment will be rescheduled. If you have recorded your temperature at home and it is 37.8° C (100° F), we ask that you call the office to reschedule your appointment. Thank you for your cooperation.

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1 - 299 Wayne Gretzky Pkwy., Brantford, Ontario, N3R 8A5, Canada - 519-720-9119
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