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3007 Spring Mill Dr
Springfield, IL 62704
(217) 546-8100 – Springfield
(217) 876-1708 – Decatur
Hours: M-F 7:30 AM - 4:30 PM
Have you had a fever, cough, shortness of breath, sore throat, any new loss of smell or taste, muscle pain,
or flu-like symptoms in the past 14 days?
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 Central Illinois in the last 14 days?
Have you been in contact with anyone who has traveled to Illinois or Central Illinois from somewhere else?
I agree to contact Oral & Facial Surgeons of Illinois if I develop any of these symptoms within 14 days of my last visit to an OFSI office.