COVID-19 Screening

  • Ready to come in?

    Please complete COVID-19 screening form below. If you have any questions call us on (615) 348-1008.


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  • COVID-19 Screening

    People who are well but who have a sick family member at home with COVID-19 should consider postponing elective treatment.
  • Positive responses to any of these COVID-19 questions would likely indicate a deeper discussion with the dentist before proceeding with elective dental treatment.



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  • Important: You consent to sign this document electronically.