COVID-19 Questionnaire

Let's Safety Measures

We are now open with enhanced safety measures!

As per the guidelines, we upgraded our HVAC system, purchased enhanced PPE, and implemented new COVID-19 protocols to keep you safe.

Please fill out the following Questionnaire before visiting the office.

COVID-19 Questionnaire

Please complete the Government COVID-19 Self-Assessment within 24 hours prior to your appointment.
• Children and patients with accessibility needs may be accompanied by ONE parent/guardian.
• Use the hand sanitizer provided at the entrance before entering the office.
• Temperature will be taken at the office using a contactless thermometer and we will be asking the screen questions again once you arrive.
• Please bring own mask to the office and wear until treatment begins in the operatory room.

Once you arrive outside the office, please call us at 416-696-1800 to let us know you’ve arrived and stay in the parking lot and do not enter the office. Once it is your turn, we will call you to let you know we are ready to see you.

Have you had close contact with anyone with acute respiratory illness or travelled outside of Ontario in the past 14 days? *

Do you have a confirmed case of COVID-19 or had close contact with a confirmed case of COVID-19?* *

Do you have any of these symptoms in the below? *

1- Fever, new onset of cough, worsening chronic cough, shortness of breath or difficulty breathing?
2- Sore throat, difficulty swallowing, altered taste or smell sensation?
3- Chills, headaches or unexplained fatigue/malaise/muscle aches?
4- Nausea, vomiting, diarrhea or abdominal pain?
5- Pink eye? runny rose or nasal congestion without other known cause?

Are you over the age of 70 AND experiencing delirium, unexplained or increased falls, acute functional decline or worsening chronic conditions? *

Have you ever been tested for COVID-19? *

What were the results of the test?

Positive
Negative

Please mentioned the result of your test ? Positive or Negative.

Notes or details *

Name *

First

Last

BOOK TODAY !

Get In Touch

We try to check our emails as frequently as we can but we highly recommend that you call to schedule your dental appointment especially if you are in need of immediate dental care. We look forward to hearing from you!

CALL ME

416-696-1800

EMAIL ME

info@teethcare.ca

VISIT US

2107 Danforth Ave, Toronto, ON M4C 1K1

Email *

Office Hours

Monday 10:00AM - 7:00PM
Tuesday 10:00AM - 7:00PM
Wednesday 10:00AM - 7:00PM
Thursday 10:00AM - 7:00PM
Friday 10:00AM - 7:00PM
Saturday 9:00AM - 5:00PM