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  • HOME
  • PATIENT CENTRE
    • Patient Forms
      • New Patient Form
      • Medical History Update
      • 5-Year Medical History Update
      • Covid-19 Patient Screening Form
      • COVID-19 Pandemic Dental Risk Consent
  • SERVICES
    • Emergency Services
      • Emergency Dental Exams
      • Dental X-Rays
      • Cuts & Lacerations
      • Dental Root Canal
      • Dental Filling Cavities
      • Crowns & Bridges
      • Repair Broken Teeth, Fillings, Crowns & Dentures
      • Replacement Of Fillings & Crowns
      • Removal Of Foreign Bodies
      • Treatment Complications
    • Cleaning and Prevention
    • Complicated Tooth Extractions
    • Dental Restorations
    • Cosmetic Dentistry
    • Periodontal Disease
  • FOR STUDENTS
  • BLOG
    • News
  • SERVICE AREAS
    • Waterloo
      • Beechwood Waterloo Ontario
      • Beechwood West-Ontario
      • Clair Hills-Ontario
      • Colonial Acres-Ontario
      • Upper Beechwood-Ontario
      • View All Areas
  • Book An Appointment
Covid-19 Patient Screening Form
  • Covid-19 Screening Form

    Waterloo Emergency Dental Centre

    258 King Street North, Unit #7,
    Waterloo, Ontario, Canada N2J 2Y9
    Phone: (519) 883-0505

  • DD slash MM slash YYYY

  • Factors such as old age, diabetes and end-stage renal disease are generally not considered immunocompromised. Examples of being immunocompromised include individuals:
    • undergoing cancer chemotherapy
    • with untreated HIV infection with CD4 T lymphocyte count less than 200
    • with combined primary immunodeficiency disorder
    • on prednisone medication - more than 20 mg per day (or equivalent) for more than 14 days
    • on other immune suppressive medications.



  • • Fever and/or chills
    • Extreme tiredness Cough or barking cough
    • Sore throat Shortness of breath
    • Runny or stuffy/congested nose Decrease or loss of taste or smell
    • Headache
    • Muscle aches/joint pain
    • Nausea, vomiting and/or diarrhea
    • Abdominal pain
    • Pink eye

    Select “No” if all of these apply:
    • you do not have a fever, and
    • your symptoms have been improving for 24 hours (48 hours if you have nausea, vomiting, and/or diarrhea)


  • Any “yes” response (other than Q1) must be discussed with the managing dentist immediately.

    When you arrive at the office, you will be asked to sanitize your hands.
  • DD slash MM slash YYYY

About Our Dentist Office

Waterloo Dental Centre specializes in providing excellent emergency and non emergency dental care to patients in the Waterloo, Ontario area. Many dental problems need to be addressed immediately to prevent the condition from worsening, which is why it is our mission is to serve you as quickly as possible, to avoid any pain or increase in damage.

Waterloo Dental Centre

  • 258 King Street North, Unit #7
    Waterloo, Ontario, Canada, N2J 2Y9
  • (519) 883-0505
  • SMS (519) 904-4431
  • [email protected]

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