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Breastfeeding Center of Pittsburgh

4070 Beechwood Blvd
Pittsburgh, PA 15217

Breastfeeding Center of Pittsburgh

Home
Clinician Resources
Pre-Visit
Offices

Our Practice
Team
BF 101
Mom Stories
- Featured Stories
- Testimonial Archive
Classes
Your Visit

COVID Screen

COVID-19 Screening

To help keep everyone safe and healthy, please fill out our COVID-19 Screening below.

Patient's Name*
First Last
Patient's Date of Birth*
MM
DD
YYYY
Does the patient have a fever (temperature > 100.4 F)?*
- Yes
- No
Does the patient have a new or worsening cough?*
- Yes
- No
Does the patient have difficulty breathing or shortness of breath?*
- Yes
- No
Does the patient have a loss of taste or smell, or a sore throat?*
- Yes
- No
Has the patient been, for at least 15 minutes, in close contact (< 6 feet) with someone with a laboratory confirmed case of COVID-19?*
- Yes
- No
Has the patient or anyone in your household been tested for COVID-19 in the past 14 days?*
- Yes
- No
Please indicate who and when, and whether they were positive.

Reach all of our offices at: 412-246-4726

Squirrel Hill/
Greenfield

4070 Beechwood Blvd
Pittsburgh, PA 15217

Cranberry/
Seven Fields

671 Castle Creek Dr
Seven Fields, PA 16046

Pleasant Hills

810 Clairton Blvd
Pittsburgh, PA 15236

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Home
Clinician Resources
Pre-Visit
Offices

Our Practice
Team
BF 101
Mom Stories
- Featured Stories
- Testimonial Archive
Classes
Your Visit