Covid-19 Information

Ahead of your dental appointment with us, you may have been directed to this page. Below are two forms which you must complete prior to your visit to the practice.

The Preparation for Dental Treatment Form includes information to prepare you for your appointment, to explain the changes and protocols that we have put in place and to provide you with reassurance regarding your safety.

The Covid Screening Form should be completed no more than 48 hours before your visit.

Please read and complete all of this page, working your way all through to the very bottom of the of this page.

PLEASE NOTE you will press the SUBMIT button 2 times to complete.

Covid Screening Form

If you are a Parent/Guardian, please fill this in on behalf of the patient attending. This form should be filled in not more than 48 hours before your appointment.

First Name

Last Name

Have you had a fever or felt hot/feverish in the last 14-21 days?

Are you having shortness of breath or other difficulties breathing?

Do you have a cough?

Any other flu-like symptoms, such as gastrointestinal upset, headache or fatigue?

Have you experienced recent loss of taste or smell?

Are you in contact with any confirmed COVID-19 positive patients?

Are you aged over 60?

Do you have heart disease, lung disease, kidney disease, diabetes or any auto-immune disorders?

Have you travelled in the past 14 days?

Positive responses to any of these would likely indicate a deeper discussion with the dentist before proceeding with elective dental treatment. Please print full name here as a form of signature.

Date

MM

DD

YYYY

Please continue reading to the end and sign final form at the end.
Thank you

Covid-19 Dental Treatment Form

Please note the information is only relevant at the time of sending and is subject to change at time. Guidance can change quickly in relation to the alert level.

We are pleased to announce, that following government advice, we can now see patients for their general dental care.

Whilst we are able to re-open, we must take measures to ensure your safety and that of our staff. Part of this involves giving you an update on the steps we are taking.

Infection control has always been a top priority. Our practice follows stringent standards of infection control so that when you receive care, it is both safe and comfortable. We are now focusing on new practice protocols in order to operate a safe and efficient dental practice for all our patients, our staff and our wider community following the COVID-19 crisis.

Although, we will take every step to ensure that your visit is as safe as possible, it is important that you understand that a dental practice can never entirely eliminate the risk of transmission of diseases such as Covid-19. Therefore, you must decide whether your visit is necessary at this time. You may wish to defer your appointment until a later time and we will be happy to discuss this further with you.

You will note some changes when it is time for your next appointment. We are making these changes and revising our protocols to help protect you, our patients, and team.

Before we can make your appointment

We will contact you to carry out a telephone triage to assess your dental problem and also carry out a Covid-19 risk assessment
Based on the triage process we can then decide on the most appropriate way for you to be managed

Before you arrive at the practice please:

You must read this form in its entirety
Thoroughly brush your teeth just before arrival
Wash your hands for 20 seconds before leaving your home.

When at the practice, we will ask you to:

Complete a quick Covid-19 screening process and consent form if this was not done at home
Use the hand sanitiser provided.

To ensure a safe environment we have:

Installed perspex panels or ‘germ-guards’ along the reception desk
Clearly markings to permit social distancing
Managed appointments to allow for social distancing between patients
Set up of daily health screening checkpoint and log for the screening of all staff entering the workplace
Minimise staff interaction
Equip our dental staff with additional PPE when in surgery
Decontaminate communal areas prior to practice opening, at lunchtime and at the end of the day
Use video and phone consultations whenever possible
Remove newspapers and magazines from the waiting room.

The measures above are based on our own risk assessment and on advice from our professional bodies. The advice may change rapidly and we will keep you updated should this be the case.

Regardless of whether we are open or closed, you can still contact us.

What else do you need to know

A number or procedures in dentistry are considered as Aerosol-Generating Procedures (AGPs). Some examples of AGPs include, taking full mouth x-rays, using a dental waterspray, any ‘drilling’ procedures or use of the ultrasonic scaler. These procedures create a mist within the surgery which needs to dissipate before we can safely see the next patient. Current guidelines require us to wait for up to 30 minutes after any AGP before seeing the next patient. This will have a significant impact on the number of patients we can see in a day and will add extra surgery time to any AGP. These guidelines will be regularly reviewed and will relax when the ‘alert’ level reduces.
AGPs require specific Personal Protective Equipment (PPE). This will be required for the dentist, hygienist and/or nurse who are looking after you. For AGPs, the operator and their assistant will need to wear a respirator mask, gown and visor. Hopefully, this will prepare you for the unusual appearance of the staff at your upcoming visit… Don’t worry, it’s still us!

We are here for you

We are available 7-days a week regarding any dental problems or concerns you may have during this outbreak. We will be able to offer advice, prescribe pain relief and antibiotics should your symptoms meet certain criteria. For dental problems we are unable to manage, we have access to refer patients to the COVID-19 dental emergency Hub network.

You can telephone the practice on 01707 874 063 or email [email protected]

We look forward to seeing you again and are happy to answer any questions you may have about the steps we are implementing to keep you, and every patient, safe in our practice.

Confirmation

Please print full name here as a form of signature to show you have read and understood this form

I had read and understood the information in the document.

Yes

Having considered the information in the document I am happy to proceed with my appointment.

Yes

Date

MM

DD

YYYY

If you would like your own printed version of these forms for your records please click button below.

CLICK TO PRINT & DOWNLOAD for BOTH FORMS