I, (patient/guardian) knowingly and willingly consent to have dental treatment during the COVID-19 pandemic. I understand that the COVID-19 virus has a long incubation period during which carriers of the virus may not show symptoms and still be highly contagious. It is impossible to determine who has it and who does not given these circumstances.

Dental procedures create water spray, which is how the virus is spread. The ultra-fine nature of the spray can linger in the air for minutes to hours, which can transmit the COVID-19 virus. I understand that due to the frequency of visits of other dental patients, the characteristics of the virus, and the characteristics of the dental procedure, that I have an elevated risk of contracting the virus simply by being in the dental office.

I have been aware of the Public Health Ontario, RCDSO and CDC/US guidelines that recommend essential care under the current pandemic.