COVID-19 Pre-Screening Questionnaire

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.

COVID-19 Pre-Screening Questionnaire
If you answered ‘NO’ to Q1, please proceed to Q9 and Q10. Only answer Q9 and Q10 if you have not received your second vaccination does for COVID-19