The Ministry of Health requires all patients to complete this COVID-19 pre-screening questionnaire. All information is strictly private and is protected by doctor-patient confidentiality. The periodontist will review the questions and explain any that you do not understand.
Any “YES” response (other than Q1) must be discussed with the managing dentist immediately. Symptomatic patients OR those with a positive COVID-19 test must only be seen in-person for urgent or emergent care: Non-urgent or non-emergent care must be deferred.
Based on results:
Immunocompromised individuals that have symptoms of COVID-19 or test positive for COVID-19 should stay home (self-isolate) for 10 days and until:
- symptoms have been improving for at least 24 hours (or 48 hours if you had nausea, vomiting and/or diarrhea) and
- there’s no fever and
- you do not develop any additional symptoms.
Non-immunocompromised individuals that have symptoms of COVID-19 or test positive for COVID-19 should stay home (self-isolate) until symptoms have been improving for at least 24 hours (or 48 hours if you had nausea, vomiting and/or diarrhea) and
- there’s no fever and
- you do not develop any additional symptoms.
Screening form questions based on the Ministry of Health Self-Assessment Screening Tool