Prescreening Questionnaire

Viva Dental Wellness is taking every precaution to ensure we can continue to deliver quality dental care to our patients while following strict health safety protocols. If you have an appointment booked at Viva Dental Wellness, we kindly request you to review the Appointment Pre-Screening Questionnaire below. Please contact us if you have any questions or concerns.

If you answer “YES” to any of the below questions, please contact our clinic immediately at 780-760-8482 so we can discuss your upcoming appointment.

  • Do you have a fever or have felt hot or feverish anytime in the last 10 days?
  • Have you experienced a recent loss of smell or taste?
  • Have you returned from travel within Canada from a location known affected with COVID-19 in the last 14 days?
  • Have you returned from travel outside of Canada in the last 14 days?
  • Are you over the age of 65?
  • Do you have any of these symptoms: New or worsening cough? New or worsening shortness of breath? Difficulty breathing? Sore throat or painful swallowing? Runny nose?
  • Have you been in contact with any confirmed COVID-19 positive patients, or persons self-isolating because of a determined risk for COVID-19? (Healthcare workers who have worn appropriate PPE may answer No)
  • Is your workplace considered high risk? (Healthcare workers who have worn appropriate PPE may answer No)
  • Do you have any of the following? Heart disease, lung disease, kidney disease, diabetes or any auto-immune disorder?

If you answered “YES” to any of the above questions, please contact our clinic immediately at 780-760-8482 so we can discuss your upcoming appointment.

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