COVID-19 Patient Screening Disclosure

Please complete this form on the day of your appointment. It is extremely important that you answer these questions accurately. Please call our office after you park in our lot. Stay in your vehicle until we call you (or come get you). Read more information from Dr. Dillard about the re-opening of our office. Please let us know if you have any questions.

If you have any issues submitting the pre-screening form on this page, please click here to complete.