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If you are experiencing Chest Pain please proceed to the nearest Emergency Room. If you have Shortness of Breath call 911. Please inform staff if you believe it is related to COVID-19. Messages submitted over the weekend will be returned Monday.
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Language |
English Spanish |
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Doctor |
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Patient First Name |
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Patient Last Name |
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Date of Birth |
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Return Phone Number |
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Contact Person If other than patient |
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Preferred Time to Call Callbacks available from 8am to 4:30pm. |
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WARNING: Generic responses to “reason for contact” will not be returned. |
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Reason for Contact |
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Are you experiencing any respiratory symptoms? |
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Select |
YES NO |
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If YES: please select: |
Cough Fever Shortness of Breath Congestion Sore throat Runny nose Sneezing
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Have you been exposed to the flu or COVID-19? |
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Select |
YES NO |
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If YES: Who, When, and Where? |
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Have you or anyone you knw traveled outside of the United States recently? |
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Select |
YES NO |
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If YES: Who, When, and Where? |
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