Arrival Directions for Patients Prescreening Treatment Questionnaire

Welcome to Partners In Dental Care.  We are grateful and ready for the opportunity to serve you today!  You will experience the highest level of protection and process to minimize the risk of exposure to all bacteria and viruses.

A copy of the Arrival Directions, Prescreening Questionnaire and Health History Update are located on the front door.  Please return to your car to fill out the forms.

Upon completion, please call: 616.949.0230 to “Check In.”  Be prepared to confirm your mobile phone number so we can call you when we ready to begin your appointment.

Please remain in your car until we call you back.  A clinical team member will call your mobile phone when it is time to enter the building.  We will meet you in the foyer, take your temperature, provide hand sanitizer, and review the answers to your Prescreening Questionnaire and Health History Update.  Afterwards, you will proceed directly to the treatment room. 

If you do not have a mobile phone, please fill out the questionnaire and health history update in your car and enter the building when paperwork is finished.

Please wear your own facemask into the building.  If you do not have a mask, one will be supplied for you.  Due to the high demand of necessary personal protective equipment (ppe), there will be an additional fee of $15 on your statement.  We are optimistic that this will be a temporary fee.  Please know we are doing everything we can to eliminate any added fees to your dental care in the Covid-19 era.

Patients not needing assistance will be asked to enter building alone.  Parents, legal guardians, or patient aidsmay accompany patients to the door.  These guests may socially distance while wearing a mask in the reception room but will not be allowed in the Treatment Room.  If your guest does not have a mask, one will be supplied for them.  Alternatively, guests have the option, and are encouraged to stay in the car.

Partners in Dental Care – Pre-screening Treatment Questionnaire

1. Do you or have you had any of these flu-like symptoms in the last 14 days?                

Consistent Cough: Yes or No                         

Onset or changes in Shortness of Breath: Yes or No               

Or at least two of these symptoms?: Yes or No         

(Circle all that apply)
Fever
Chills
Repeated shaking
Fatigue
Muscle aches
Vomiting
Headache
Sore throat
New loss of taste or smell
Malaise
Nausea
Diarrhea

2   Are you awaiting results of a lab test for COVID-19? Yes or No

3.  Have you tested positive for COVID-19? If so, when? Yes or No

4. Have you or a family member previously been asked to self-isolate or self-quarantine in the past 14 days? Yes or No

5.  Have you had close contact to an individual diagnosed with COVID-19 infection in the past 14 days? Yes or No

6.   Have you traveled in the past 14 days to a region with high rates of COVID-19 disease activity? Yes or No

If “yes” to any of the above questions, delay elective treatment for 14 days, then re-evaluate.

Please contact our office (616-949-0230) if any changes in your health occur in the next 14 days.

Recent & Related

Our New Patient Safety Protocols

Our New Patient Safety Protocols

Like in other medical professions, ensuring that our staff wear proper PPE is important for everyone’s safety. When coming into our office, you’ll see all of our staff from the receptionist to your hygienist wearing a proper protective face-covering. Some staff members will also be wearing shields to protect their entire face as they work.

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Reopening Plan

Reopening Plan

Prevention starts before you come in for your appointment. Two days prior to your appointment, we will call to ask you a few screening questions. When you arrive for your appointment, we will ask the same questions again, and will take your temperature as an additional safety precaution.

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COVID-19 Update 4/2/20

COVID-19 Update 4/2/20

Due to the federal government’s extended COVID-19 recommendations, Partners in Dental Care will be closed through April 30. All patients who had appointments scheduled through the end of day on Thursday April 30 have been cancelled. If we are forced to cancel...

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Schedule an Appointment

***If your appointment was postponed due to the coronavirus pandemic, we will be reaching out soon to reschedule***

Schedule an appointment with us by calling (616) 949-0230.