COVID-19 Orthodontic Treatment Consent Form

Please select and complete the COVID-19 Orthodontic Treatment Consent Form.

This must be completed by all patients seeking face-to-face treatment to continue active treatment. Once completed, our Reception Team will contact you to arrange the next available appointment.

Patient Number will be required to complete this form. It can be found on top of any communication sent by our Practice. If you don’t know your Patient Number, please contact us at reception@orthwise.co.uk. Any submitted forms will be rejected without this number.

Due to enhanced infection control measures in-place, Parents/Guardians and Carers for those already in active treatment are asked to wait outside the practice for the duration of the appointment. If you need to discuss matters regarding on-going treatment, this can be arranged in advance of your scheduled appointment by one of our Reception Team.

PLEASE ARRIVE WEARING A FACE COVERING, YOUR TEMPERATURE WILL BE TAKEN UPON ARRIVAL – IF IT READS 37.8° OR ABOVE YOU WILL BE ASKED TO REBOOK YOUR APPOINTMENT FOR NO LESS THAN 14 DAYS LATER.

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Patient details

Patient number (Patient Clinical Number) consists of 5 digits and can be found on any emails or letters we have sent to you. Incorrect numbers entered will result in our system automatically rejecting your submission. If you don't know your Patient number, please contact us at reception@orthwise.co.uk. Any submitted forms and appointment bookings will be rejected without this number.
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