COVID-19 questionnaire

(513) 871-8488

Do you have fever or have you felt hot or feverish recently (14-21 days)?

Are you having shortness of breath or other difficulties breathing?

Do you have a cough?

Any other flu-like symptoms, such as gastrointestinal upset, headache or fatigue?

Have you experience recent loss of taste or smell?

Are you 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)

Are you currently under the care of physician for the treatment of the following…

·         Heart disease

·         Lung disease

·         Kidney disease

·         Diabetes

·         Any auto-immune disorders

If you answer yes to any of these questions please contact the office prior to your upcoming appointment.


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