Appointment Forms

We are excited to see you at your upcoming visit!

Please fill out the required pre-screening and consent forms below prior to your visit. As a reminder, we ask that you wait in your car when you arrive and a member of our team will notify you when we are ready to see you. We also ask that all patients wear a mask/face covering when entering the office. Thank you!

Covid19 Re-opening Updates

Dear Patients,

We hope you are all continuing to stay safe and healthy during this unprecedented time. As our team has communicated over the mandated shutdown, one theme has remained- we miss you! However, there is good news on the horizon. On May 19th, 2020 our office will re-open for continued dental care. As you can imagine, this shutdown has created a significant backlog of appointments that will need to be re-scheduled. As a priority, our team will be working over the next couple of weeks to reschedule those patients with pending appointments that were cancelled from March 18th – May 14th, 2020. We will make every effort to reschedule you in as timely a manner as possible!

Upon our return to the office, as with many facets of our lives, a “new normal” will exist for a period of time. Most notably, we will ask all patients to wait in their car upon arrival to their appointment. A member of our team will call you when we are ready for you to enter the office, in an attempt to respect social distancing guidelines. We also would like patients to wear a face-covering/mask with them when they enter the office. We sincerely appreciate your adherence to these new changes, as it is always our commitment to keeping our patients and staff safe and healthy.

In light of the pandemic and the extreme difficulty in sourcing necessary personal protective equipment, please note that all visits are temporarily subject to a $10 fee for the personal protective equipment required and special precautions being taken to maintain the safety of our patients and staff. This is not covered by insurance and is in addition to any fees normally associated with your visit. Your visit may include:

1. Patient Temperature screening upon entry
2. Daily employee health screening, ensuring our staff are healthy when treating you
3. Use of hydrogen peroxide/chlorhexidine oral rinses prior to evaluation
4. Adjusted appointment times to ensure adequate social distancing of all patients
5. Use of medical grade HEPA-13 air filtration, continuously in treatment rooms and common areas
6. Use of N95 respirators or ASTM level III masks combined with polycarbonate face shields
7. Disposable PPE gowns, masks, face shields, eye protection and N95 respirators (or equivalent) for all employees
8. Disinfection of all critical care touchpoints in the circle of care
9. Increased access to hand sanitizers upon entry and exit of the office
10. Taping of the office to show appropriate social distancing requirements
11. Use of specially designed High Volume Evacuation Equipment to reduce the aerosol spread in the treatment room setting.

Thank you for your support of our team during this time as we strive to provide top-notch oral health care in a setting that puts safety and health above all. We look forward to seeing you soon!

Regards,

Dr. Wagar, Chris, Shelly, Brenda, Yen, Stacy, and Daria