The ADA Division of Science advises dental professionals to request a travel history from their patients with symptoms or signs in which a Ebola infection is suspected.

We created short YAPI Travel Questionnaire that includes three questions that ADA recommends to ask.


If a patient answers No then he/she will need only to sign the questionnaire.


Otherwise YAPI will require to answer two more questions


If you would like to use this form in your practice, please click here to download. To install please follow instruction found here. Note that you can add this questionnaire to any existing package,  add to a dynamic package, or use as a standalone form.

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