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Lehman & Menis Oral & Maxillofacial Surgery

Crystal Lake
850 Munshaw Ln
Crystal Lake, IL 60014

(815) 459-7400

Mon, Tue, Thu: 8:00AM-4:00PM
Wed, Fri: 8:00AM-3:00PM

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COVID-19 Risk Assessment

Have you been near or had physical contact with anyone who has had these symptoms or has been diagnosed with COVID-19 in the past 14 days?

Have you traveled out of Illinois or northeast Illinois in the last 14 days?

Have you been in contact with anyone who has traveled to Illinois or northeast Illinois from somewhere else?

In the past 7 days have you had...

Any fever reducer medication(s), such as but not limited to, Tylenol®, Motrin®, ibuprofen and aspirin?

Temperature of 100.0 or above?

Shortness of breath or trouble breathing?

Loss or decrease in your sense of taste and/or smell?

Any of the following symptoms? If yes, check all that apply:

I agree to contact Lehman & Menis Dental Implant and Oral Surgery Specialists if I develop any of these symptoms within 14 days of my last visit to an OMS office.

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