ARTHUR J. APPEL, DDS Monmouth Orthodontics
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Consenting For Treatment During The COVID-19 Pandemic

I acknowledge and understand that there is an increased risk that COVID-19 can be transmitted in any place of public accommodation, including a dental office, and I have been informed that my dentist desires to protect the safety of the dental office and the patients, staff and other individuals who come upon the premises.

Accordingly, as a precondition to rendering treatment, I understand that I will need to complete a questionnaire to screen for symptoms commonly associated with COVID-19, including fever, shortness of breath, dry cough, running nose or sore throat and that I have not, within the past 14 days, travelled by airplane, been in close proximity (less than 6 feet proximity) at a gathering of 10 or more persons, or had close contact with a person who has confirmed positive or suspected to be positive for COVID-19.

YOU WILL NEED TO COMPLETE THIS CONSENT AGAIN, IN WRITING BEFORE YOUR APPOINTMENT
I Consent To Treatment
I Do Not Consent To Treatment
Schedule your appointment today, call us at (732) 845-0500. You may fax the office at (732) 577-0251.
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American Association of Orthodontists. My Life. My Smile. My Orthodontist.
Diplomate American Board of Orthodontics

Conveniently Located off Rt. 9

221 Taylors Mills Rd.
​
Manalapan, NJ 07726

© 2020 Dr. Arthur J. Appel, DDS  ALL RIGHTS RESERVED                                       Website Development: Ahoy! Marketing 
  • Home
  • About
    • Meet Dr. Appel
    • Covid-19 Updates
  • Services
    • Braces
    • Clear Aligners
  • Smiles
  • New Patients ▼
    • Billing & Insurance
    • New Patient Forms
    • Virtual Office Tour
  • Contact
    • Request Appointment