COVID-19 Coronavirus Patient Self-Assessment Tool
Texas Fertility Center (TFC) is committed to protecting the health and safety of our patients. As our country and our world deal with the novel coronavirus (COVID-19) pandemic, our team is taking measures to protect you. This includes asking you certain questions when you visit our office.
We appreciate you answering the following self-assessment questions each time you visit our office.
- Have you had the COVID vaccine Yes No
- If yes, 2nd dose date:___________________
- If no, have you had COVID? Yes ( date: ________ )No
- Are you currently experiencing symptoms of COVID? Yes No
- If yes, please explain:________________________________________________
