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COVID-19 Health & Screening Questionnaire

COVID-19 Health & Screening Questionnaire

  • Have you been in contact with someone diagnosed with COVID-19 either within 72 hours before their symptoms started, within 7 days after their symptoms began, or within 3 days after their symptoms ended?
  • Do you currently have symptoms that may be due to COVID-19, particularly a cough, difficulty breathing, feeling feverish as well as, in some cases, diarrhea, muscle aches, fatigue, sore throat or runny nose?
  • In the last 14 days have you been traveling outside of your home and NOT PRACTICING social distancing? Please see "Social Distancing" definition below. If you HAVE been practicing social distancing, select NO. (Social Distancing: staying at least 6 feet away from other to avoid contact with people who may be infected. Avoided leaving the house unnecessarily. When outside you have used a mask to protect yourself and washed your hands with soap and/or hand sanitizer).
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Artemedica is committed to providing our patients with the most advanced services, performed by the most trusted providers. Artemedica offers cosmetic surgeries, non-surgical treatments and products that keep you looking & feeling your absolute best.

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  • california medical association
  • the california society of facial plastic surgery
  • facial plastic surgery
  • american board of otolaryngology
  • american medical association
  • american board of facial plastic and reconstructive surgery