To ensure the health and safety of both our patients and staff during the COVID-19 pandemic, we require submission of consent in order for patients and staff to attend appointments.
All patients are required to review and submit a consent form prior to coming in for their appointment.
PLEASE COMPLETE THE PATIENT CONSENT FORM BELOW:
* Indicates Required – Please note all statements below must be confirmed and checked prior to form submission.
CMOH Order 05-2020 legally obligates any person who has the following cough, fever, shortness of breath, runny nose, or sore throat (that is not related to a pre-existing illness or health condition) to be in isolation (quarantine) for 10 days from the start of symptoms, or until symptoms resolve, whichever takes longer. If they are exhibiting any of these symptoms, it is suggested they complete the COVID-19 Self-Assessment online tool to determine if they should be tested.
Thank you from the Team at West Calgary Periodontics!
Alternatively, please complete & submit the COVID form below!
The form can be downloaded and submitted by email.
Please Do Not Use This Form To Cancel Or Reschedule An Existing Appointment
Messages sent using this form are not considered private. Please contact our office by telephone if sending highly confidential or private information. Please review our privacy policy and website terms of use prior to submitting your form request.
Monday: Closed
Tuesday to Friday: 8:00am to 4:00pm
Weekends & Statutory Holidays: Closed
Plenty of Free Onsite Parking
West 85th Professional Building is Wheelchair Accessible including Elevator & Washrooms
Call us at (403) 727-5307 to schedule your appointment today!
No referral is necessary.
