“The patient should be asked about the presence of symptoms of a respiratory infection and history of travel to areas experiencing transmission of COVID-19 or contact with possible patients with COVID-19. If the patient is afebrile (temperature < 100.4˚F) and otherwise without symptoms consistent with COVID-19, then emergency dental care may be provided using appropriate engineering controls, work practices, and infection control practices.”
Have you traveled in the past two weeks? YesNo
Have you test positive for COVID-19? YesNo
Have you been in recent contact or caring for someone who tested positive for COVID 19? YesNo
In the past few days have you experienced any of the following?