SCREENING QUESTIONS

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If you answer YES to any of the questions below, please call our office at 217-483-3545.

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On the day of your appointment, please call us from your car when you arrive. We have moved to 345 N Main in Chatham.

1.

Have you had a fever, cough, or any flu-like symptoms in the last 14 days?

2.

Have you been tested for COVID-19 in the last 14 days?

3.

Have you been or are you currently in contact with anyone confirmed COVID-19 positive? *Patients who are well but who have a sick family member at home with COVID-19 should consider postponing elective treatment.

4.

Do you have heart disease, lung disease, kidney disease, diabetes or any auto-immune disorders?

5.

Have you traveled out of the country in the past 14 days?

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If you answered no to all these questions, please remember to confirm your appointment through text or email.

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**Please do not submit any Protected Health Information (PHI)