COVID-19 Questionnaire and Informed Consent Online Form

New Guidelines to Keep Our Patients Safe and Healthy

Prior to entering the office, all patients will need to complete and submit the ADA COVID-19 Patient Screening Form (link below) to help screen for possible symptoms. Please have it completed before visiting the office.


patient information form for dentist ADA COVID-19 Patient Screening Form

If you are uncomfortable coming into the office for any reason, we are happy to move an existing appointment out to a later date. If you have any questions about the new protocol or about scheduling please call the office at 336-288-4499.

We're excited to see your smiling faces again!