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Father & daughter

To Our Valued Patients

COVID-19 has been a very difficult time for all of us. We understand that many of you have been forced to wait for dental care with the shutdown of dentistry.

The Royal College of Dental Surgeons of Ontario has now allowed resumption of all normal dental procedures.

As regulated health care professionals, our Dental Team will continue to abide strictly by the specific guidelines. We are continuing to monitor the COVID-19 situation and will continue to use full PPE (personal protective equipment) and to practice social distancing along with all other recommended safety guidelines.

For your peace of mind and preparation the following process is to provide a safe dental treatment experience including, but are not limited to, the following:

Day Before Your Appointment

You will need to review, answer, and sign the COVID-19 Patient Pandemic Consent Form and bring it with you to your appointment. We are also taking the time to update all patient and medical history information. You can email these forms back to us.

COVID-19 Pandemic Dental Treatment Consent Form

Patient name

I understand the novel coronavirus causes the disease known as COVID-19. I understand the novel coronavirus has a long incubation period during which carriers of the virus may not show symptoms and still be contagious.

I acknowledge Westfort Family Dental staff need to be within 6 feet of me during a procedure, so they will be unable to social distance.

I understand that dental procedures create water and/or blood spray, which is one way that the novel coronavirus can spread.

I understand that due to the frequency of visits of other dental patients, the characteristics of the novel coronavirus, and the characteristics of dental procedures, I have an elevated risk of contracting the novel coronavirus simply by being in a dental office.

I confirm that I am not presenting any of the following symptoms of COVID-19 identified by the Ontario Health Services:

Fever> 38℃

New cough or worsening chronic cough

Sore throat or painful swallowing

New or worsening shortness of breath

Difficulty breathing

Flu-like symptoms

Runny nose

I confirm I know that there are categories of people who are considered to be at high risk. I understand the high-risk category factors are being 65 years of age or older, heart disease, lung disease, kidney disease, diabetes, or any auto-immune disorder.


I fall into the high-risk category

and my dentist and I have discussed the risks, and I have agreed to proceed with treatment.

I confirm that I am not currently positive for the novel coronavirus.

I confirm that I am not waiting for the results of a laboratory test for the novel coronavirus.

I verify that I have not returned to Ontario from any country outside of Canada, whether by car, air, bus, or train in the past 14 days.

I understand that any travel from any country outside of Canada, including travel by car, air, bus, or train, significantly increases the risk of contracting and transmitting the novel coronavirus. The Ontario Health Services require self-isolation for 14 days from the date a person has returned to Canada.

I understand that Ontario Health Services has asked individuals to maintain physical distancing of at least 2 metres (6 feet), and it is not possible to maintain this distance and receive dental treatment.

I verify that I have not been identified as a contact of someone who has tested positive for novel coronavirus or been asked to self-isolate by Ontario Health, Communicable Disease Control or any other governmental health agency.

I verify the information I have provided on this form is truthful and accurate. I knowingly and willingly consent to have the above listed dental treatment completed during the COVID-19 pandemic.


Printed Name


Your message was sent successfully. Thanks.

Please also fill out your Medical History Form

Upon Your Arrival at the Office

  • Please wait outside the office and CALL to let us know you have arrived.

  • Your screening will be reviewed BEFORE entering the office.

  • We will be taking your temperature.

  • Patient will sanitize hands before the appointment.

  • ONLY scheduled patients will be allowed entry into the office. **Underage patients can have a guardian attend but, they must be screened & sign a COVID patient consent form as well.

  • Hand sanitizer is available on the countertop at the front desk and throughout the clinic for your use.

  • Plexiglas screens are added to the front reception desk

  • We will ask that you continue to practice social distancing measures in common areas of the office at all times.

  • The public areas, including restrooms, will be cleaned and sterilized frequently throughout the day.

  • There will be no physical contact with patients except for treatment.

  • Note - Any patients showing signs of a fever or other symptoms of illness will be asked to reschedule their appointment.

Your Treatment

  • All rooms will be COMPLETELY sterilized before each patient is seated.

  • The dental team has all the needed personal protective equipment (PPE).

  • During patient care, appropriate masks, face shields, and gloves will be worn by everyone.

  • All surfaces that came in contact with the patient will be wiped with disinfectant, and that includes the patient chair too.

Checking Out After Your Appointment

  • Patients will wash/sanitize hands after the appointment prior to going to the front desk.

  • You can sign any insurance forms. Cashless or no contact payment is strongly encouraged.

  • After every transaction, the checkout desk will be wiped with a disinfectant.

We are proceeding with an abundance of caution, but we want you to feel as confident as we do that any visit you make to our office will be a safe one. We look forward to seeing you.

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We're Open 6 Days a Week!

Let us know what time works for YOU!

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Nervous About the Dentist?

We offer oral sedation and nitrous oxide sedation to help calm your nerves.

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