If answered YES to any of the above questions, a team member One Dental Place will reschedule you and your child(ren)’s dental appointment. Please contact your doctor for further advice.
If you do not meet the criteria above, please sign below indicating that you have been provided with this information.
I HAVE REVIEWED THE ABOVE CRITERIA. MY CHILD(REN) AND I DO NOT HAVE SYMPTOMS AS DESCRIBED. (Please list the full name and date of birth of each child present at today's appointment.)