Hello- I really appreciate the Wellness Form that you've created and we're planning on using when the office re-opens. The AAO is recommending offices have patients sign a supplemental informed consent, we'd love to be able to add this to the Wellness Form to combine them. I'm sure other ortho offices would appreciate and use this as well. Thanks!

The wellness form needs customization for each office. We are a pediatric office and those questions do not pertain to our office. We are now having to verbally ask questions over the phone. Please make a custom form. Thank you!

I would like the wellness form to be able to be edited, there is more I would like to add to the form or change it up according to the patient.

Is there a way to give the patient/caregiver the ability to sign (or at least initial) the form at the bottom?

The wellness form idea is great, but it needs to be customizable ASAP as the screening questions by the CDC have recently changed (and may change again in the future). Also, is there a way to give the patient/caregiver the ability to sign (or at least initial) it at the bottom?

Would like to check off patients wellness forms once they have been viewed to keep track of which ones we have taken note of.

Have an alert of some sort, similar to when a fax is coming in, that would tell us if a patient's wellness form came back with symptoms. This would allow us to check our admin portal ASAP to contact and r/s the patient.

Please configure Wellness Forms (that have been filled out by the patient & returned) so that they can be saved in more than just the PNG format. We use SoftDent and it won't recognize PNG files. Features like the Wellness Forms can be a great tool for us, but only if the whole process remains user-friendly for both the patient & the office staff. The extra steps of having to print & scan, or convert to a format such as JPG becomes very time consuming when applied to every patient in a day. Thank you!

We'd like to incorporate a consent for treatment during COVID-19. It could be added to the wellness form for convenience

WELLNESS SCREENING FORM: This should definitely be editable. There are more questions that we would be asking the patient that are similar but should be asked according to the ADA's screening form....such as flu-like symptoms (not just fever), loss of taste/smell, and travel in last 14 days.

Customize Wellness form questions

Hello! I have TWO suggestions hoping happen.
1) I am hoping you will be able to let us edit the wellness form OR add these questions to the form, in addition to what is already on the form. These are the additional questions...
- Have you experienced a loss sense of taste or smell in the last 14 days?
- Have you experiencing muscle pains in the last 14 days?
- Have you experienced extreme fatigue in the last 14 days?
- Are a frontline worker?
- Have you or anyone you have interacted with tested positive for the COVID-19 virus?

and...
2) If we could have 2 current questions on the wellness form edited, to reflect 14 days instead of 3 and 7 days (this is for questions #2 having a fever in the past 3 days and #4 have you come in contact with someone exp. covid19 symptoms in 7 days). Just changing those to say 14 days.

Thank you!!

Please allow a DELETE button for wellness forms to be deleted after downloading. I would like to be able to delete or mark out what i have already done. Thank you!!

We would to update the Covid-19 wellness form to what the ADA is recommending. Here is the form https://www.mandarindentalpros.com/wp-content/uploads/Patient-Screening-Form.pdf

Please make the wellness forms with the ability to edit or customize. The English form should not ask for symptoms within the last 3 days while the Spanish form asks for symptoms within the last 14. The forms are lacking in the manner the screening questions are asked. Please refer to the ADA screening form that most of the dentists are using for reference

Is it possible to have the last question on the "Covid Wellness form" to be... 14 days instead of 7 days?

We need to be able to move the wellness forms to the patients journal or office documents. We do not have the time to print every wellness form for patients charts nor the amount of paper and ink for 20+ patients daily, it takes alot of time to print each one. Thanks!

On the Wellness Form, the question regarding Covid19 exposure asks if they have had it within the last 7 days, however the questionnaire that comes directly from the American Dental Assoc (ADA) asks within last 14 days, I feel it should be updated to 14 days or at least editable.

Wellness Form-We are wondering if you can add an advisory note at the top of the form example: You have come to our office today for a routine dental evaluation and/or treatment that will be done during the COVID-19 pandemic. Please be advised of the following: While our office complies with State Health Department and the Centers of Disease Control and Prevention infection control guidelines to prevent the spread of the COVID-19 virus, we cannot make any guarantees. Ou staff are symptom-fee and to the best of their knowledge have not been exposed to the virus. However, since we are a place of public accommodation other persons (including other patients) could be inficted with or without their knowledge. In order to reduce the risk of spreading COVID-19 we have asked you a number of screening questions . for the safety of our staff, other patients, and yourseld, please be truthful and candid in you answers.

Something like this above statement if possible to add to Wellness Form to help cover our business. Thank You in advance!

Danielle
6:08 pm
Is there away to get a time stamp which includes time and date on the wellness form on each individual patient sheet when it is downloaded so we can put it in the patient chart