Pre-appointment COVID-19 screening questionnaireBefore attending your appointment, please complete our pre-appointment COVID-19 screening questionnaire. Have you tested positive for COVID-19 in the past 10 days? Yes No Have you had any symptoms of COVID-19 in the past 10 days to include: A new, persistent cough – coughing for more than an hour or more than 3 coughing episodes in 24-hour period A high temperature or fever Loss of, or change in, sense of smell or taste Yes No Has anyone in your household or support bubble had any COVID-19 symptoms in the past 10 days? Yes No Have you been in close contact with someone diagnosed with COVID-19 in the past 10 days? Yes No Have you been advised to self-isolate as part of the “Test, Trace and Protect” strategy? Yes No Have you been advised of a close contact by the StopCOVID NI app in the past 10 days? Yes No Have you travelled outside of the common travel area in the last 10 days? https://www.nidirect.gov.uk/articles/coronavirus-covid-19-travel-advice Yes No Are you in a vulnerable group?If Yes, please contact our Receptionist on 02825652931 https://www.nhs.uk/conditions/coronavirus-covid-19/people-at-higher-risk/whos-at-higher-risk-from-coronavirus/ Yes No Full Name Date of Birth Email Please note the following: Access to Braid Dental is restricted to patients with pre-booked appointments Patients should attend at their appointment time and ring the doorbell - a team member will meet you at the door Patients should attend alone unless an accompanying person is necessary Please bring only essential personal belongings to your appointment Toilet use is restricted A one-way system is in place for entry and exit to Braid DentalWe respectfully request and appreciate your cooperation as we implement the policies and procedures now required to ensure that Braid Dental is a safe environment for all patients and staff