As it relates to the COVID-19 infection, are you completing an isolation or quarantine period or awaiting COVID-19 test results?
You may schedule your in-office vaccination appointment after the release from isolation / quarantine period or once you have received negative COVID-19 results.
Yes
No
Have you felt ill with any COVID-19 or flu-like symptoms in the past 48 hours?
Symptoms such as: Fever, chills, cough, shortness of breath or difficulty breathing, fatigue, muscle or body aches, headache, new loss of taste or smell, sore throat, congestion or runny nose, nausea or vomiting, or diarrhea? You may schedule your in-office flu vaccination appointment after the release from isolation / quarantine period or once you have received negative COVID-19 results.
Yes
No
Since you have been in close contact with a confirmed COVID-19 case, please select "yes" to attest that you will schedule your appointment outside of the 10 days quarantine window.
Have you been in close contact with anyone with laboratory confirmed COVID-19 in the last 10 days?
Yes
No
Has it been at least 2 weeks since you were fully vaccinated against COVID-19, OR has it been at least 90 days since you recovered from COVID-19?
Yes
No
Will the patient be physically located in New York State and visible to the provider during the entire Video Visit?
Yes
No
At this time we are unable to conduct TeleHealth visits for our patients who are not physically located in New York State during the entire Video Visit.
If you are an existing patient of ACPNY, please contact your care team for further assistance.