Coronavirus Questionnaire

Hello Children’s Urology Families,

As the COVID-19 crisis evolves, we wanted to let you all know that we are implementing all recommended precautions to provide a safe environment for our families and staff.  We are still treating patients in our office.

We are asking that only one (1) guardian or designee accompany the patient to our office.  Please no additional guests. 

At this time, we ask that you participate in a self-questionnaire before coming into our office for any upcoming appointments:

1) Have you recently traveled outside the US in the last 14 days?

  • Yes
  • No

2) Have you had contact with someone who has traveled outside the US in the last 14 days?

  • Yes
  • No

3) Are you currently having any of these symptoms (or within the last 48hours); fever, cough or shortness of breath?

  • Yes
  • No

4) Have you been exposed to anyone with confirmed or suspected COVID-19?

  • Yes
  • No

5) Have you been diagnosed with RSV or influenza in the last 2 weeks?

  • Yes
  • No

6) Have you had vomiting or diarrhea in the last 2 weeks?

  • Yes
  • No

If you answered yes to any of the above questions, we ask that you call our office at (512) 472-6134 to reschedule any upcoming appointments.

Thank you,

Children’s Urology