COVID-19 Screening for Redwood Smiles
Positive responses to any of these would likely indicate a deeper discussion with the dentist before
proceeding with elective dental treatment
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Email *
Patient's Name *
Please enter full name, First and Last
Patient's Date of Birth
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Where can we call/text you? *
Texting is a fast and easy way for us to communicate with you.  Texting may not always be 100% secure depending on the mobile service you use. Respond with YES if you'd like to text with us. This consent will apply to you and all of your dependents being treated at our practice. *
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