Pre-Attendance Covid-19 Screening Form

Pre-Attendance Covid-19 Screening Form2022-07-28T13:28:28+01:00
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 experienced 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.

Is your age over 60? *
Have you travelled in the past 14 days to any regions affected by COVID-19? (as relevant to your location) *
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