COVID-19 Consent Form COVID-19 Questionnaire
All My New Periodontal & Dental Implant Patients,
I want to thank all of you for choosing my practice and to let you know how much I and my staff appreciate all of you. We closed for 2 months to prepare for re-opening and have been quite busy since then.
I want to take a moment of your time to let you know some of the numerous measures we all have taken to make sure your visits to my office for periodontal and dental implant treatments are safe.
Environmental / Engineering Modifications
• Multiple medical grade HEPA filters positioned around the office to filter out harmful organisms including viruses
• UV light radiation to eradicate organisms
• After hours ozone generators to kill organisms
• Extra oral high speed evacuation system to remove possible aerosols from procedures
• Room washed down in between each patient
• Counters, chairs, doorknobs cleaned frequently
• The office and the building have been professionally decontaminated on several occasions
• Pre-appointment phone health screening
• Temperature checked on arrival
• Restricted number of patients in reception room to maintain social distancing
• Decreased number of appointments per day to allow for more disinfection procedures
• Controlled check out to maintain social distancing
Office Personnel Protocol
• Masks (N-95, KN-95, level 1, 2 and 3 surgical masks)
• Disposable isolation gowns
• Headgear (shields) when indicated
• Several sets of new uniforms which are changed throughout the day and laundered daily
• Twice daily temperature checks and health questionnaire daily
We want to protect you, our patients, ourselves, and all our families. This scary time will pass, and we will all get through this together with a “new normal”. Please call us if you have any questions.
Thank you again for your trust in me and my team. We all look forward to seeing you soon.
To your good oral health,
Kenneth M. Lubritz