We have implemented these and other procedures and protocols for both your safety and ours. We are going above and beyond to do everything possible to keep you safe.
• Please bring a current medication list
• Please arrive 15 minutes prior to your dental appointment.
• Please call when you arrive in the parking lot and we will ask you these questions.
1) Do you or anyone in your household have any respiratory issues?
2) Have you traveled outside of NC in the past 14 days?
3) Have been in close contact with a patient with COVID-19?
4) Do you or anyone in your household have a fever?
5) Does anyone in your household have any trouble breathing?
• We will then schedule your next appointment and collect any copay/balance over the phone.
• We will come out to get you when your chair is ready.
• We will need you to wear a mask upon entering the office.
• We will take your temperature and have you read over and sign the following consent form.
COVID-19 Pandemic Emergency/Elective Treatment Consent Form
I knowingly and willingly consent to have emergency/elective 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. It is impossible to determine who has it and who does not given the current limits in virus testing.
Dental procedures create water spray which is how the disease is spread. The ultra fine nature of the spray can linger in the air for minutes to sometimes hours, which can transmit 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 procedures, that I have an elevated risk of contracting the virus simply by being in the dental office.
I confirm that I am not presenting any of the following symptoms of COVID-19 listed below:
• Fever
• Shortness of Breath
• Dry Cough
• Runny Nose
• Sore Throat
I understand that air travel significantly increased my risk of contracting and transmitting the COVID-19 virus, and the CDC recommends social distancing of at least 6 feet for a period of 14 days to anyone who has, and this is not possible with dentistry
• I verify that I have not traveled outside of NC in the last 14 days.
