General Covid Form

SimplyTeeth Essex, Online Consultation Form

Thank you for choosing SimplyTeeth

As part of our attempt to reduce contact time and decrease the rate of infection, we are asking all patients to prefill Covid Risk assessments and medical history forms. Please fill and sign and submit these secure forms so that they can be loaded onto your record cards before your visit.

You may experience increased waiting times as we will try and minimise the amount of patients we see, and you may be asked for deposits in advance for the increased price of PPE to be done over the phone prior to your visit.
Please help us to keep both you and Us safe.

Please answer all questions.


Pre Visit Questions


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How can we help


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I confirm that all the information I have provided here is correct to the best of my knowledge and that I agree to the terms and conditions of SimplyTeeth Essex.

 

 

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