11904 Darnestown Rd., Suite C., North Potomac, MD 20878
301-977-1441
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Home
Office
About Our Doctor
Our Staff
Office Tour
Service Areas
Doctor Referral
Refer a Friend
Appointment Request
Glossary
Community Service
Contests
Patient Info
When to See an Orthodontist
First Visit
Financial & Insurance
FAQ
Patient Forms
Common Problems
Emergencies
Orthodontics and Dental Hygiene
Brushing and Flossing with Braces
Foods to Avoid with Braces
Treatment
Early Treatment
Adolescent Treatment
Adult Treatment
Types of Braces
Damon Metal Braces
Palatal Expanders
Temporary Anchorage Device (TADs)
Thumb and Finger Appliances
Retention
Digital Dental Impressions
Digital X-Rays
Invisalign
Invisalign
Invisalign Videos
Invisalign Teen
Invisalign FAQ
Invisalign vs. Braces
Contact Us
Blog
North Potomac Orthodontics
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Patient Screening Questionnaire
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When to See an Orthodontist
First Visit
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Patient Forms
Patient Screening Questionnaire
Common Problems
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Orthodontics and Dental Hygiene
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Foods to Avoid with Braces
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Patient Screening Questionnaire
COVID-19 Wellness Screening Form
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Do you/they have a fever or have you/they felt feverish recently (the last 14-21 days)?
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Are you/they having shortness of breath or other difficulties breathing?
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Do you/they have a cough or have had a cough recently?
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Any other flu-like symptoms, such as gastrointestinal upset, headache or fatigue?
(Patients who are well but who have a sick family member at home with COVID-19 should consider postponing elective treatment.)
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Have you/they experienced recent loss of taste or smell?
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Are you/they in contact with any confirmed COVID-19 positive patients or have you/they been exposed to COVID-19?
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Are you/they over the age of 60?
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Do you/they have heart disease, lung disease, kidney disease,diabetes or any auto-immune disorders?
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