Our goal is to provide a safe environment for our patients and team and to advance the safety of our local community. This document provides the information we ask you to acknowledge and understand regarding the COVID‐19 virus.
1) I understand that carriers of the virus may not show symptoms and may still be contagious.
2) I understand that my dental office is taking all the necessary precautions, according to the current guidelines from the ADA and CDC, to limit viral transmission.
3) I agree to notify the dental office if within 14 days if I become ill with COVID-19 symptoms, I have been exposed to a patient with COVID 19, or test positive for COVID-19.
4) I consent to have dental treatment at today's visit.