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Patient Advisory and Acknowledgement
Receiving Dental Treatment During the COVID-19 Pandemic

Dear Patient: 

Our office complies with the State Health Department and the Centers for Disease Control and Prevention infection control guidelines to prevent the spread of the COVID-19 virus, but we cannot make any guarantees. 

Our staff are symptom-free and, to the best of their knowledge, have not been exposed to the virus. However, since we are a place of public accommodation, other persons (including other patients) could be infected, without their knowledge.

In order to reduce the risk of spreading COVID-19, below are a number of "screening" questions. For the safety of our staff, other patients, and yourself, please be truthful and candid in your answers. Thank you for your cooperation!

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