SUPPLEMENTAL HEALTH QUESTIONNAIRE

Orthodontic Treatment in the Era of COVID-19

If you have been exposed to a communicable disease, you may spread the disease to the orthodontist, orthodontic staff, or other patients/parents in the practice. Therefore, prior to each appointment, we will be asking the following questions to reduce the chances of transmission:

Do you, your child, others accompanying you to today’s appointment or anyone you have recently been in contact with have any of the following symptoms?
Have you, your child, others accompanying you to today’s appointment or anyone you have recently been in contact with tested positive for or been diagnosed as having COVID-19 or any other communicable disease?

If yes provide approximate dates of illness

through

UBICACIÓN

164 Ferry Street 2nd Floor

Newark, NJ 07105

Email:ironboundbraces@gmail.com

Tel: (973) 344-1888

Horario de apertura:

Mon, Wed & Fri: 9am - 5pm

Tue & Thu: 10am - 6pm 

​​Saturday: 9am - 2pm​

Sunday: Cerrado

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© 2019 Ironbound Braces