The Barlow Building
5454 Wisconsin Avenue, Suite 1550
Chevy Chase MD, 20815

Patient Advisory and Acknowledgment Receiving Dental Treatment During the COVID-19 Pandemic

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Dear Patient:

We're grateful that you've chosen us to provide your dental care and we are looking forward to seeing you at your upcoming appointment.

You should know that our office has taken the steps to provide more safety measures than recommended by the Maryland Health Department and CDC guidelines to prevent the spread of COVID-19 virus.

Our staff are symptom-free and, to the best of their knowledge, have not been exposed to the virus. However, since we are a place of public accommodation, and other persons (including other patients) could be infected, with or without their knowledge.

In order to reduce the risk of spreading COVID 19, we have asked you a number of "screening" questions below. For the safety of our staff, other patients, and yourself, please be truthful and candid in your answers. Your temperature will be taken as you arrive, and we will be happy to see you provided that your temperature is under 100.4 Fahrenheit.

We will not be able to accommodate your appointment without having received this before you arrive.

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