Safety and Precautions Page Survey

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Safety & Precautions Page Survey
Basic Info
Policies & Protocols

Please select the policies and protocols that you have implemented in your practice:

We check your temperature at the door.
We have altered our schedule to reduce the number of patients in the office at once. This helps us social distance and maintain infection control.
Our hours of operation remain the same.
All staff are screened and have their temperature taken daily.
Office staff wear a mask at all times.
Clinical staff wear personal protective equipment (PPE).
After every patient, we thoroughly disinfect the exam room, door handles, surfaces, etc.
We have added more frequent disinfecting cycles.
We have upgraded our air filtration systems.
All staff are trained and continually updated on office protocols.
We have removed magazines, children's toys and so forth from the waiting area (since those items are difficult to clean and disinfect.)
We have removed or added extra space between chairs in the waiting area.
We are asking patients to wait in their car and call to check-in.
We do not allow guests inside (aside from a caretaker or parent).
We require patients to wear a mask on arrival.
We ask screening questions before appointments over the phone.
We ask screening questions again at the appointment.
Would you like to add a patient screening form PDF?
We offer online patient forms.
We offer online payment services.
We have a PPE surcharge.
Additional Info

Thank you for taking the time to complete this survey. Please hit the "Submit" button and you are done!

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