Patient Referral Form

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We are strictly following the recommendations set by the CDC, ADA & VDA. Our team-members take significant precautions to maintain infection control, privacy & safety protocols. 

Please read the following:

1- Please complete the mandatory health screening questionnaire when scheduling. 

2- Please call the clinic & wait in your car or outside upon arrival. MASK IS REQUIRED.

3- Your temperature & Blood Oxygen level will be checked once entered.

4- You are required to wear a mask prior to entering the clinic.

5- Hand sanitizer will be provided upon arrival.

Your cooperation is highly appreciated.