Questions to be Answered Prior to Return to Dr. Wei Dental Clinic During Coronavirus Infection
Have you contracted COVID19 (Yes/No) or contacted with anybody diagnosed with COVID19 (Yes/No)?
Do you have fever (Yes/No), runny nose (Yes/No), sneezing (Yes/No), cough (Yes/No), Loss of smell or taste (Yes/No) or raspy voice (Yes/No)?
2020/ / Sign____________________
Text the form at 770-814-2282. Thanks.
Xin Wei, DDS, PhD, MS 1st edition 04/20/2020, last revision 04/24/2020