Supplemental Informed Consent COVID 19 Patient Details

Supplemental Informed Consent COVID 19 Contact Information

Supplemental Informed Consent COVID 19

As with the transmission of any communicable disease like a cold or the flu, you have the potential to be exposed to COVID-19, also known as Coronavirus, at any time or in any place. Be assured that we have always followed local, state, and federal regulations and recommended universal personal protection and disinfection protocols to limit transmission of all diseases in our office. As we continue to do so, you will see we are taking extreme measures to ensure your safety as well as the safety of our staff. In addition, we have implemented further personal protective equipment use as recommended by the CDC and have new protocols to limit your contact within the office. 


Despite our careful attention to sterilization, disinfection, and use of personal barriers, there is still a chance that you could be exposed to an illness in our office, just as you might be at your gym, grocery store, or favorite restaurant.  Social distancing nationwide has reduced the transmission of Coronavirus. Although we have taken measures to provide social distancing in our practice, due to the nature of the procedures we provide, it is not possible to maintain social distancing between the patients, dentist, dental staff and sometimes other patients at all times.

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