Patient Consent Form

For treated during the Covid-19 pandemic

Patient Consent

I hereby consent to being treated during the Covid-19 pandemic.  I trust that my treating dentist and the dental practice have taken all steps possible to reduce any exposure risk to Cov-Sars-2 virus.  I trust that they are following current best available evidence regarding treatment, protective equipment, cleaning, and decontamination.

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Lismore House Dental in Carlisle

Lismore House,
Lismore Street, Carlisle, CA1 2AH
T: 01228 528022

Mark Fortune B.D.S. 113720
Rebecca Fortune B.D.S. 113722
Lismore Care Ltd. 10292404
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