Please fill out (ONLY ONE/SERVICE) and submit the following questionnaire before every visit.
If the answer to any of the following questions is yes, please cancel your upcoming appointment and reschedule for a later date.
Health experts are still learning the details about how this new coronavirus spreads. Other coronaviruses spread from an infected person to others through; the air by coughing and sneezing, close personal contact (such as touching or shaking hands), touching an object or surface with the virus on it, then touching your mouth, nose, or eyes. Please contact Oregon Health Authority for further information regarding the new coronavirus.