Patient Screening Form

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Patient Screening Form

Dear Patient:

We hope  you and your family are  healthy. Our people group has experienced much throughout the most recent couple of months, and we all are anticipating continuing our ordinary schedules. While numerous things have transformed, one thing has continued as before: our pledge to your wellbeing.

Disease control has consistently been a top need for our training and you may have seen this during your visits to our office. Our disease control forms are made with the goal that when you get care, it’s both sheltered and agreeable. We need to educate you regarding the contamination control methodology we follow in our training to protect patients and staff.

Our office follows disease control proposals made by the American Dental Association (ADA), the U.S. Habitats for Disease Control and Prevention (CDC) and the Occupational Safety and Health Administration (OSHA). We follow the exercises of these organizations with the goal that we are forward-thinking on any new decisions or direction that might be given.

At the point when it is the ideal opportunity for your next arrangement we caused changes to assist with ensuring our patients and staff.  Please read the accompanying:

*    Upon showing up to the workplace please type into the internet browser on your telephone (Safari, Chrome) and adhere to the directions utilizing the patient’s name. That will place the patient in a virtual lounge area that our front work area staff can see.

*    Leave the site running and don’t enter the workplace until you are reached and advised to do as such.

*    When called clean hands with gave hand sanitizer before entering the workplace.

*    Only the patient/parent will be permitted into the workplace and must be wearing a cover.

*    Parents must stay in sitting area. Nobody with the exception of staff and patient are allowed in the center territory.

*   The patient will have their temperature taken with a touchless thermometer before being permitted into the facility zone.

*   Our entire office will be purified multiple times day by day with a nontoxic antiviral sanitizer.

*   We will be obliging any senior patients that might want an early morning arrangement a couple of days a week.  Please call our office.

We anticipate seeing you again and are glad to respond to any inquiries you may have about the means we take to keep you, and each patient, safe in our training.

Much obliged to you for being our patient. We esteem your trust and devotion and anticipate inviting back our patients.


Dr. Abbas and Staff

Do you/they have fever or have you/they felt hot or feverish recently (14-21 days)?
Are you/they having shortness of breath or other difficulties breathing?
Do you/they have a cough?
Any other flu-like symptoms, such as gastrointestinal upset, headache or fatigue?
Have you/they experienced recent loss of taste or smell?
Are you/they in contact with any confirmed COVID-19 positive patients? (Patients who are well but who have a sick family member at home with COVID-19 should consider postponing elective treatment.)
Is your/their age over 60?
Do you/they have heart disease, lung disease, kidney disease, diabetes or any auto-immune disorders?
Have you/they traveled in the past 14 days to any regions affected by COVID-19? (as relevant to your location)
Positive responses to any of these would likely indicate a deeper discussion with the dentist before proceeding with elective dental treatment. • For testing, see the list of State and Territorial Health Department Websites for your specific area’s information.
(413) 592-2342

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