COVID-19 Pandemic Dental Treatment Consent Form 

​I confirm that I am NOT presenting any of the following symptoms of COVID-19 identified by Alberta Health Services: 

Do you have a fever > 38°C?
New cough or worsening chronic cough?
Sore throat or is it painful swallowing?
New or worsening shortness of breath?
Difficulty Breathing?
Flu-like symptoms?
Runny nose?

or

Thank you for submitting your COVID-19 Consent Form