covid-19 Treatment Consent

Covid-19 Treatment Consent form

Due to the COVID-19 Pandemic we have instituted an additional dental treatment consent form. Please submit the form prior to arrival.

If you’re able to wear a mask to your appointment, please do so. Otherwise, we will provide you with one upon entry into the clinic.

Are you presenting any of the following symptoms of COVID-19 identified by Public Health Services?

Printable format of above form

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Covid-19 Treatment Consent Form

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