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Physician/Nurse Response Request

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.
* Language English     Spanish    
* Doctor
* Patient First Name
* Patient Last Name
* Date of Birth
* Return Phone Number
  Contact Person
If other than patient
  Preferred Time to Call
Callbacks available from 8am to 4:30pm.
WARNING: Generic responses to “reason for contact” will not be returned.
* Reason for Contact
Are you experiencing any respiratory symptoms?
* Select YES     NO    
  If YES: please select: Cough
Fever
Shortness of Breath
Congestion
Sore throat
Runny nose
Sneezing
Have you been exposed to the flu or COVID-19?
* Select YES     NO    
  If YES: Who, When, and Where?
Have you or anyone you knw traveled outside of the United States recently?
* Select YES     NO    
  If YES: Who, When, and Where?