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Total Care Dental COVID-19 Pre-Screening Questionnaire

We are excited to have the opportunity to welcome you back to Total Care Dental! Our office has always utilized personal protective equipment (PPE) that has exceeded all the CDC guidelines, however, in light of the COVID-19 Pandemic we have instituted additional guidelines and protocols to ensure your safety.  Part of our enhanced protocols requires that we complete this questionnaire prior to your appointment. We will have to reschedule your appointment if we are unable to complete this step.

Please fill out this short questionnaire 48-72 hours before your appointment.  If you have questions, please feel free to call our office at (608) 274-1911.

  • On the day of your appointment, please arrive 5-10 minutes prior to your scheduled appointment to minimize waiting times.
  • Please wear a mask as you enter the practice.
  • You will be greeted by a team member to take your temperature upon entry.  
    • If you have a temperature >100ºF, you will be asked to reschedule your visit.
  • Please limit your personal belongings.  Please come by yourself, if you need an escort, please limit it to one additional person.
  • We will have limited seating in the waiting room.
  • Fever
  • Chills
  • Repeated shaking
  • Fatigue
  • Muscle aches
  • Vomiting
  • Headache
  • Sore throat
  • New loss of taste or smell
  • Malaise
  • Nausea
  • Diarrhea

Our primary concern is to protect the health and wellness of you and our team. We ask everyone to complete and submit our screening survey before coming in. Thank you for your patience, and stay safe.

Our Reviews

Five Star Reviews - Celebrating our fantastic five-star reviews!

My son and I recently came in for teeth cleaning. During his cleaning, his hygienist discovered a fe...

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Five Star Reviews - Celebrating our fantastic five-star reviews!

Total Care Dental provides thorough, comprehensive dental care. From my first visit years ago I was ...

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Five Star Reviews - Celebrating our fantastic five-star reviews!

EVERYONE on the staff makes you feel as if you are family! We love Total Care Dental! We recommend i...

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Five Star Reviews - Celebrating our fantastic five-star reviews!

Today was wonderful. I not only got a wonderful cleaning, but I received very helpful advice about h...

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Five Star Reviews - Celebrating our fantastic five-star reviews!

I have an absolutely terrible fear of the dentist, but Dr. Clark has turned that around! He was extr...

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Five Star Reviews - Celebrating our fantastic five-star reviews!

I am completely satisfied with the work done by Dr. Salzmann and with his attention to achieve perfe...

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Five Star Reviews - Celebrating our fantastic five-star reviews!

I've never used the words "amazing" and "dentist" in the same sentence before! Total Care Dental (TC...

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