Central Coast Dentist | Gosford Family Dentists
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COVID-19 Online Screening Questionnaire

We are a registered NSW COVID-SAFE business. The safety of our patients and staff is of utmost importance to us. Working to fight the spread of COVID-19 is critical so that we can continue to deliver the optimum level of oral health care our valued practice family.

As part of our precautionary measures during these unprecedented times, please kindly complete this online screening questionnaire prior to your arrival on your appointment day. This will help us protect patients, visitors and staff from any potential risks.

Thank you for your understanding and co-operation.

Please call us on (02) 4325 3221 to discuss rescheduling your appointment if you are unwell or experiencing any flu-like symptoms, or have had an exposure risk to COVID-19.
Appointment Date *
Signed by: *
Please type your name and it will be accepted as your digital signature for the purpose of the questionnaire.