• COVID-19 PANDEMIC DENTAL TREATMENT CONSENT FORM

  • I confirm that I am not presenting any of the following symptoms of COVID-19 identified by Alberta Health Services:

  • or

  • but I have consented to treatment.

  • I confirm that I am not currently positive for the novel coronavirus.

  • I understand that any travel from any country outside of Canada, including travel by car, air, bus or train, significantly increases my risk of contracting and transmitting the novel coronavirus. Alberta Health Services require self-isolation for 14 days from the a person has returned to Canada.

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