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.

  • Do you have any of these symptoms?
    Choose any or all that are new, worsening and not related to other known causes or conditions.