COVID – 19 Protocol Consent
We hope you and your family are in good health. Our community has been through a lot over the last few months, and all of us are looking forward to resuming our normal routines. While many things have changed, one thing has remained the same: our commitment to your safety.
Here at Confi Dental LLC, we are taking all the necessary precautions that are at our disposal to protect our patients and staff from the spread of infection incompliance with CDC (Centers for Disease Control and Prevention), the ADA (American Dental Association) guidelines and the Governor of Connecticut orders. Please be advised that there may be a risk in being in the proximity of dentists, patients, or staff. We are taking precautions to limit the spread of disease, yet there is still a possibility of transmission. There is a Personal Protective Equipment additional cost of $12. Please remember that your dental insurance is your responsibility. We assist you in the process. We must stress the fact that you, the patient, are responsible for the COVID PPE cost, regardless of your dental benefit in dollars based on available information from your dental insurance company. I understand and accept the treatment done today. I agree to the financial responsibility for total fees not covered under my dental insurance