Pre-Appointment Health Screening Form (COVID-19)

Following the outbreak of COVID-19 dental practices need to be able to look after the safety of their staff and patients in relation to the virus. Understanding if patients are potentially infectious prior to their appointment will allow practices to manage appointments safely. This pre-appointment questionnaire collects the relevant patient information and saves it back in Exact, triggering medical alerts where required.

This is available in EXACT Version 13.144 and above for customer using Patient Portal (It is not available for Clinipad).


What questions does the form ask?

There are different forms available based on regional advice, there are two main forms available which are based on guidance from governing bodies in the United Kingdom and New Zealand. We aim to update these based on the latest guidance as quickly as possible.

Patients must answer YES or NO to every question and sign the form to save it.

UK Form - based on guidance from the NHS


New Zealand Form - based on guidance from the Ministry of Health


How are forms sent to the portal?

  • Forms will be automatically requested when automatic appointment reminders are sent.

    You must include the [patient.portalURL] merge field in any appointment reminder where you wish for patients to request their forms as this it what triggers Exact to automatically request required forms.

  • You can also manually request the form via the patient portal window launched on the patient file

How does Exact decide if a patient needs to complete the form?

Forms are considered valid if they are completed within 14 days of the appointment.

Exact is defaulted to 14 days but this is configurable, if you would like to change this please contact support.

Where is the form saved?

  • In the contacts tab named ‘Health Screening’

Double clicking the line in Exact will display the completed form so that you can view the answers.

What if the patient answers yes to a question?

  • The relevant medical alert on the medical tab will be ticked automatically

    • On the default form, answering yes to any of the questions will result in an infectious alert

    • On the long for, answering yes to the first 5 questions will result in an infectious alert. Answering yes to the last 6 questions will result in a an alert alert, which indicates that they are potentially vulnerable.

  • A pop-up medical note will be added on the medical tab informing that the patient is potentially infectious, potentially vulnerable, or both

  • On the arrivals tab reception can see the patient’s medical alert for appointments today and in the future to manage appointments safely.
    The arrivals tab allows for scrolling through future days easily to review future appointments as well.

How do I know that the patient has completed their covid triage form?

  • The heart icon on the arrivals tab represents the health screening form. It will display green if there is a valid form, black if there is a form an outstanding form.
    The arrivals tab allows for scrolling through future days easily to review future appointments as well.


  • a new icon displays on the appointment card on the appointment book if the patient has outstanding forms in their portal


How does the patient complete their form?

Patients can complete their form on any personal device by logging into their portal using the link which you can include in your appointment reminders and other communications.

Once they have completed and saved the form it will be saved in their portal for them to view and it will also be saved in Exact for the practice to review if required.