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We require this COVID-19 Patient Consent form to be completed
To ensure the health and safety of both our patients and staff during the COVID-19 pandemic, we require submission of a COVID-19 patient consent form in order for patients and staff to attend appointments.
All patients are required to review and submit a consent form prior to coming in for their next dental appointment.
PLEASE COMPLETE THE PATIENT CONSENT FORM BELOW:
* Required
CMOH Order 05-2020 legally obligates any person who has the following cough, fever, shortness of breath, runny nose, or sore throat (that is not related to a pre-existing illness or health condition) to be in isolation (quarantine) for 10 days from the start of symptoms, or until symptoms resolve, whichever takes longer. If they are exhibiting any of these symptoms, it is suggested they complete
the COVID-19 Self-Assessment online tool to determine if they should be tested.
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Thank you from the Team at Tooth Suite Family Dentistry!
Disclaimer
Dr. Marianne Stelmaschuk is a Lloydminster General Dentist. She is not a specialist in Cosmetic or Family Dentistry. Cosmetic and Family Dentistry are not specialties recognized by the Alberta Dental Association & College of Dental Surgeons of Alberta (CDSA). She provides Cosmetic and Family Dental procedures such as Porcelain Veneers, Dental Crowns, Invisalign, and Teeth Whitening as part of her General Dentistry license. As a Lloydminster Family Dentist, she provides General Dental procedures for all ages within the family. Dr. Prabhjot Singh is a licensed Oral and Maxillofacial surgeon and can offer Oral Maxillofacial specialty services as part of his license.