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Dentist Federal Triangle | 955 L’Enfant Plaza SW Suite 1205, Washington DC, DC 20024, US | (202) 488-8300

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Dentist Federal Triangle

955 L’Enfant Plaza SW Suite 1205,
Washington, DC, DC 20024, US

(202) 488-8300

Monday: 7:30 am – 4:00 pm
Tuesday: 7:30 am – 4:00 pm
Wednesday: 7:30 am – 4:00 pm
Thursday: 7:30 am – 4:00 pm
Friday: Closed
Saturday: Closed
Sunday: Closed

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Dental News in Federal Triangle DC

Dentist Federal Triangle

June 1, 2023

Are Dental Veneers Right for Me? | Dentist Federal Tringle DC

We often have visitors to our office ask about solutions for fixing stained teeth or filling in gaps between teeth. We sometimes suggest veneers. Veneers are one cosmetic option available for correcting your smile. Here’s what you should know about veneers, and whether they are right for you and your smile. What Are Veneers?A Veneer […]
Read More >>
May 15, 2023

You Need to Know About Oral Thrush: Here’s Why | Federal Triangle Dentist

Even a healthy mouth is lined with bacteria. Normally, your daily oral hygiene routine helps prevent oral health complications. However, it is possible to develop an excess of bacteria and fungi, which can lead to additional problems. Here’s what you should know about oral thrush and what you can do to prevent it. What is […]
Read More >>
May 1, 2023

Gaining Wisdom on Wisdom Teeth | Dentist Federal Triangle DC

Wisdom teeth are the last new teeth that will enter your mouth. Most patients have some form of complications resulting from their wisdom teeth. Did you know that your wisdom teeth can impact your overall health? Here’s what you need to be aware of regarding your wisdom teeth. The Basics Typically, your wisdom teeth will […]
Read More >>

© 2022 L’Enfant Plaza Dental Arts | Dentist Federal Triangle | 955 L’Enfant Plaza SW Suite 1205, Washington, DC, DC 20024, US | (202) 488-8300

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Medical History

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Are you taking any medications, pills, or drugs?
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Are you on a special diet?
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Do you use tobacco?
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Please tell us how often and what type of tobacco consumption

Recreational drug and/or alcohol use, combined with local anesthesia may cause a life-threatening emergency.

Have you ever been advised that you require antibiotics prior to a dental appointment?
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Do you take, or have you taken, PhenFen or Redux?
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Have you ever taken Fosomax, Boniva, Actonel or any other medications containing bisphosphonates?
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Women (Please check all that apply)
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AnemiaChemotherapyColdSores/FeverBlistersCortisoneMedicationExcessiveBleedingFrequent CoughFrequent HeadachesHay FeverHemophiliaHigh Blood PressureHives or RashKidney ProblemsLiver DiseaseParathyroid DiseaseRecent Weight LossRheumatismShinglesSpina BifidaStrokeThyroid DiseaseVenereal DiseaseArthritis or GoutBlood DiseaseBruise EasilyCongenital Heart ProblemsDiabetesDrug/Alcohol AddictionEmphysemaFrequent UrinationHeart MurmurHeart Valve or PacemakerHerpesHypoglycemiaLung DiseaseRheumatic FeverTuberculosisUlcers or GI ProblemsAsthmaChest PainsConvulsionsEasily WindedExcessive ThirstFrequent DiarrheaGenital HerpesHeart Attack/Heart FailureHepatitis (B or C)Low Blood PressureIrregular HeartbeatLeukemiaMitral Valve ProlapseRadiation TreatmentsRenal DiseaseScarlet FeverSickle Cell DiseaseStomach/Intestinal DiseaseSwelling of LimbsTonsillitisYellow JaundiceArtificial JointBlood TransfusionCancerCurrently PregnantDizziness or FaintingEating DisorderEpilepsy or SeizuresGlaucomaHeart TroubleHepatitis (A)HIV-AIDS-ARCJaw Joint PainPsychiatric CareSinus ProblemsTumor or GrowthX-ray/ChemotherapyNo to All

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To the best of my knowledge, the questions on this form have been accurately answered. I understand that providing incorrect information can be dangerous to my (or patient’s) health. It is my responsibility to inform the dental office of any changes in medical status.

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Patient Information

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Relationship to Patient

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Emergency Contact

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Referral Information

Please share with us how you heard about our office. Thank you. *
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Signature *

Your health and safety always rank #1 with us.

You’ll notice a few differences when you visit, but the care you receive won’t be one of them. Here are a few things you’ll see:

We will use no-touch mobile communications such as text, email and phone.
Hand sanitizer is readily available.
We’re using some new protective gear.
If you’re not feeling well, we can help you reschedule.

There are also a few things behind the scenes that might not stand out. Just a few include:

Added cleaning and disinfection of public spaces.
Continued strict sterilization monitoring.
More training than required on protective measures

Did we mention that we’re excited to see you? But before we do, please take a minute to fill out the pre-appointment screening and health history forms by clicking below! Thank you.

COVID-19 Pre-Screen Questionnaire

First Name *

Last Name *

Contact Phone Number *

Email Address

Do you or have you had a fever of above 100 degrees in the past three days? *
NoYes

Have you recently lost or had a reduction in your senses of smell or taste? *
NoYes

Do you have a sore throat? *
NoYes

Do you have a dry cough? *
NoYes

Do you have a runny nose? *
NoYes

Have you been in contact with someone who has tested positive for or suspected they were positive for Covid-19 (corona virus?) in the last two weeks? *
NoYes

Have you tested positive for Covid-19 or are you awaiting test results for Covid-19 within the last 10 days? *
NoYes

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