Guideline and Patient Consent for Dental treatment During Covid-19 Pandemic

Guideline and Patient Consent for Dental Treatment During Covid-19 Pandemic

Following guidelines set by BC health authorities, our office has established an updated set of policies and measures to provide a safe environment for our staff and our patients while providing dental treatment. We are providing high safe environment while you are visiting our office.

Fully Vaccinated Staff:  All of our staff and practitioners are now fully vaccinated.

Reduced Contacts:  installation of transparent barriers in reception area, modification of schedule system to minimize the amount of person to person contact and elimination of waiting area congestion to allow 6 feet distance at all times. Our new policy reduces the amount of contact between patient to patient and patient with staff.

Procedural Dental Barriers: We use dental barriers and disinfectants to eliminate the aerosol spread at the source during aerosol generating procedures for each patient.

Extra Oral Vacuum System: Powerful extra oral high volume evacuators with HEPA filter prevents any environment contamination during dental procedures.

Air Purifier with UV and HEPA Filter: Our state of the art air purifier filters all possible air particles while using safe internal UV light to kill all micro organisms and viruses.

Please help us keep everyone safe by doing your part to follow the guideline below;


Please follow the step by step instruction;

1- Brush AND floss your teeth at home or work before coming to our office and do not eat after brushing and flossing.

2- Wearing facemask is optional when visiting our office.

3-When arriving, please do NOT enter the office. Please let us know when you arrive outside the office and use the chair set outside left to the office entrance. Our staff will guide you through the procedure and let you know when to enter the office. Please keep a minimum distance of 6 feet from staff and other visitors.

4- One of our staff will measure your temperature using touch less thermometer and take you directly to the dental operatory room. 

5- We will try to accommodate as much as treatment needed on any single visit to reduce the number of visits per person.

6- Upon completion of your treatment, please do not leave the chair until one of our staff guides you to the outside.

7- To minimize spending time in reception area, we do our best to complete all administrative works such as billing insurance company, if applicable and postings before you would be guided to outside. We attempt to do the billing matters using touch less machine or in case you are paying by credit card, you can provide the number to the receptionist in order to be entered in to the machine.

8- Any paperwork such as receipts can be email to you at your request.

As per guideline, each patient for each dental visit should acknowledge and consent to receive dental treatment and to confirm that they do not have any signs and symptoms of Covid-19. Please read the following form and acknowledge and consent to your upcoming treatment within 24 hours of your appointment to keep your appointment in place.


I understand the novel coronavirus causes the disease known as COVID-19.

I understand that by traveling outside my residence, I will have higher risk of exposure to virus in any public area including a dental office.

I confirm that I am not presenting any of the following symptoms of COVID-19:
• Fever > 37.5 C
• Cough
• Sore Throat
• Shortness of Breath
• Flu-like symptoms

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

I confirm that I am not waiting for the results of a laboratory test for the novel coronavirus.

I verify that I have not been advised by any officials for self isolation at the time of my dental appointment. 

I understand that BC’s Provincial Health Officer has asked individuals to maintain social distancing of at least 2 meters (6 feet).

I verify that I have not been identified as a contact of someone who has tested positive for novel Corona virus or been asked to self-isolate by BC’s Provincial Health Officer, the Communicable Disease Control or any other governmental health agency.

Please do NOT send this consent form IF you have any doubt that you might be suspicious to have any type of flu OR you might be at high risk. In this case call our office immediately for instruction.