Supplemental Health Form: Covid -19

To ensure the health and safety of our patients, parents, and the Gass Orthodontics team, please take a moment to fill out this Covid-19 screening questionnaire prior to your orthodontic appointment.  In addition to this questionnaire we will be taking steps to ensure patient and staff safety, including limiting the number of people in the office to maintain distancing, and temperature checks with a no-contact thermometer prior to entry.  We would ask that adults and teens that are comfortable come in unaccompanied and that only one parent accompany our younger patients.  We will accommodate both parents for our children/teens who are coming in for new patient exams.

Thank you for your patience during this challenging time.  We miss your smiles and look forward to seeing you again.

Dr Gass and Team


COVID-19 Informed Consent Form


Orthodontic Treatment in the Era of COVID-19

Thank you for your continued trust in our practice. As with the transmission of any communicable disease like a cold or the flu, you may be exposed to COVID-19, also known as “Coronavirus,” at any time or in any place. Be assured that we have always followed state and federal regulations and recommended universal personal protection and disinfection protocols to limit transmission of all diseases in our office and continue to do so.

Despite our careful attention to sterilization, disinfection, and use of personal barriers, there is still a chance that you could be exposed to an illness in our office, just as you might be at your gym, grocery store, or favorite restaurant. “Social Distancing” nationwide has reduced the transmission of the Coronavirus. Although we have taken measures to provide social distancing in our practice, due to the nature of the procedures we provide, it is not possible to maintain social distancing between the patient, orthodontist, orthodontic staff and sometimes other patients at all times.