COVID-19 Staff Consent

All Staff are Required to Complete
This Consent Form Prior to Each Shift

To ensure the health and safety of both our patients and staff during the COVID-19 pandemic, we require submission of a COVID-19 staff consent form in order for patients and staff to attend appointments.

PLEASE COMPLETE THE STAFF 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 for being an integral part of the
Tooth Suite Family Dentistry Team!

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.