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    I understand the novel coronavirus causes the disease known as COVID-19. I understand the novel coronavirus virus has a long incubation period during which carriers of the virus may not show symptoms and still be contagious. I understand that dental procedures create water and/or blood spray which is one way that the novel coronavirus can spread.
    By selecting 'None of the Above' I confirm that I am NOT experiencing any of the above listed symptoms of COVID-19
    I verify the information I have provided on this form is truthful and accurate. I knowingly and willingly consent to have dental treatment completed during the COVID-19 pandemic.