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Welcome to Arbutus Point Dental Centre
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604.224.8000
Dr. Chris Kan

 



OPEN FOR
EMERGENCIES ONLY





2696 Arbutus Street
(at West 11th Avenue)
Vancouver, BC  V6J 5L8
Canada



COVID-19
SCREENING



COVID-19
Safety Plan





Invisalign in Vancouver: straight teeth, no braces





CDA member seal.  This Kitsilano, Vancouver dentist is a CDA member.




Patient Screening Form

Please complete and submit this form to the dental office at least 48 hours in advance of your scheduled appointment.
Patient's full legal name 

Date of next appointment 
Please answer completely: Yes No
1. Do you have a fever or have felt hot or feverish anytime in the last 14 days?
2. Do you have any of these symptoms: Dry cough? Shortness of breath? Difficulty breathing? Sore throat? Runny nose? Sneezing? Post-nasal drip?
3. Have you experienced a recent loss of smell or taste?
4. Have you been in contact with any confirmed COVID-19 positive people, or anyone self-isolating because of a determined risk for COVID-19?
5. Have you returned from travel outside of BC in the last 14 days?
If yes, where?
6. Is your workplace considered high risk (e.g. routine close contact with many people)?
7. Are you over the age of 70?
8. Do you have any of the following: Heart disease, lung disease, kidney disease, diabetes or any auto-immune disorder?
Please note that no data transmission over the internet can be guaranteed to be 100% secure. As a result, we cannot guarantee the security of any information you transmit to us over the internet, and you do so at your own risk. If you would prefer to contact us by telephone to complete this screening questionnaire, please call: 604-224-8000

©2003-2020 Arbutus Point Dental Centre Kitsilano dentist  Last Updated: 14 July 2020