Covid-19 Form

1. Do you have any of the following new or worsening symptoms or signs?
New or worsening cough
Shortness of breath
Runny nose, sneezing or nasal congestion (in absence of underlying reasons for symptoms such as seasonal allergies and postnasal drip)
Sore throat
Hoarse voice
Difficulty swallowing
New smell or taste disorders
Nausea/vomiting, diarrhea,
abdominal pain
Unexplained fatigue/malaise
Chills
Headache
2. Have you traveled outside of Ontario or had close contact with anyone that has traveled of Ontario in the past 14 days?
3. Do you have a fever?
4. Have you had close contact with anyone with respiratory illness or confirmed or probable case of COVID-19?
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Dunwin Dental is always welcoming new patients at our Mississauga location. 

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