Supplemental COVID Questionnaire

To protect you and our Practice, prior to your appointment, we will be asking the following questions to reduce the chances of transmission of COVID - 19:

Have you or your child had any of the following:

***I attest these answers to be accurate to the best of my knowledge.

By answering these questions, together, we can keep Willowbrook Orthodontics safe for everyone! Please do not hesitate to contact us with any questions concerns you may have regarding in office protocols. We look forward to seeing you soon!