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Home
COVID-19
Our Team
Our Doctors
Dr. Gavin Forsyth
Dr. Benjamin Chih-I Chang
Office Tour
Procedures
Cleanings and Prevention
Fluoride Treatment
Sealants
Dental X-Rays
Home Care
Cosmetic Dentistry
Tooth Whitening
Composite Fillings
Porcelain Veneers
Porcelain Crowns (Caps)
Dental Implants
Porcelain Inlays
Porcelain Onlays
Porcelain Fixed Bridges
Periodontal Disease
Diagnosis
Treatment
Maintenance
Restorations
Composite Fillings
Crowns (Caps)
Dental Implants
Fixed Bridges
Amalgam Fillings
Invisalign
Gallery
Patient Info
Financial Policy
Appointment policy
New Patient Forms
Educational Video
Blog
FAQs
Forms
New Patient Forms
Covid Forms
Contact Us
Book Appointment
Links
COVID acknowledgement form
Please read this form and sign where indicated.
Checkbox
I understand there is currently a health pandemic associated with COVID-19 and the novel coronavirus.
I understand public health authorities have recommended maintaining social distancing of a least 2 metres (6 feet) and it is not possible to maintain this distance while receiving dental treatment.
I understand that oral surgery/dental procedures can create water and/or blood spray, and that there may be an elevated risk of contracting and spreading the novel coronavirus in a dental office.
I confirm that I do not have any two or more of the following symptoms of COVID-19: fever, new or worsening cough, sore throat, runny nose or headache, and that this is not currently a period where I am required to self-isolate for 14 days
I confirm that I have not tested positive for COVID-19 and that I am not currently waiting for the results of a test for COVID-19.
I hereby consent to have dental treatment completed during the COVID-19 pandemic.
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Clear Dental COVID-19 Safety Protocol
Learn More
Clear Dental 傳染性肺炎防護措施
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