Division Family Dental

2484 NE Division St, Gresham Or 97030


COVID-19 Patient Waiver and Consent Form

I (or my child/ward),

knowingly and willingly consent to receive dental treatment during the COVID-19 pandemic.

I understand the COVID-19 virus has a long incubation period during which carriers of the virus may not show symptoms and still be highly contagious. It is impossible to determine who has it and who does not given the current limits in the virus testing

Dental procedures create water spray. It is unclear as to how long the ultra-fine nature of the spray may linger in the air, which can transmit the COVID-19 virus.