*** Pre-Appointment Survey ***

* Please tell us your name.
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* In the last 10 days, have you had ANY symptoms such as fever, cough, headache, fatigue, shortness of breath, loss of taste/smell, or sore throat?
* If you answered yes to any of the above symptoms, have you been tested for COVID? If so, what was the result?
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* Have you been asked to quarantine in the last 10 days?
* Have you ever tested positive for COVID 19? If yes, when?
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* Are you vaccinated against COVID-19?
Please tell us your favorite skin care product or a fun fact about yourself.
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Thank you for taking our pre-appointment survey! We do have small office dogs, so please let us know if you are not comfortable around them.
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Please use this space if you have any additional comments or concerns.
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