Before visiting the surgery

If you are planning on visiting the surgery, please complete the following quick questionnaire to ensure you are Covid safe.

Do you have any of the following symptoms?:
high temperature or fever new, continuous cough*

Yes

No

Have you or a member of your household/family had a confirmed diagnosis of Covid-19 in the last 10 days*

Yes

No

Are you or any member of your household/family waiting for a Covid-19 PCR test result?*

Yes

No

Have you travelled internationally in the last 10 days to a country that is on the government Red List?*

Yes

No

Have you or a member of your household/family been advised to isolate by any NHS organisation in the last 10 days*

Yes

No

Coleman Starkey family dental practice
Timbrell Street, Trowbridge, Wiltshire BA14 8PL

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