FORMS

Forms

Register / Patient Login


Register here to become a new patient at Fox Family Dental. Please call us if you have any questions. Existing Patients can log-In to our Patient Portal to access your MyChart Records
PATIENT LOGIN

Patient Screening Form


Contact Us

Patients who are well but who have a sick family member at home with COVID-19 should consider postponing elective treatment.

Positive responses to any of these would likely indicate a deeper discussion with the dentist before proceeding with elective dental treatment.

For testing, see the list of State and Territorial Health Department Websites for your specific area’s information. 

You can also download this form below.
DOWNLOAD SCREENING FORM
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