I knowingly and willingly consent to have dental treatment completed during the COVID-19 pandemic.
I understand the COVID-19 virus has a long incubation period during which carriers of the virus may not show symptoms and still be highly contagious.
There are several modes of transmission of COVID-19 which could be present in a dental office. We are following the ADA and CDC guidelines to minimize the risk of transmission.
This patient disclosure form seeks information from you that we must consider before making treatment decisions in the circumstance of the COVID‐19 virus.
I understand that due to the frequency of visits of other dental patients, the characteristics of the virus, and the characteristics of dental prodecures, that I have an elevated risk of contracting the virus simply by being in a dental office.