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Covid consent

Covid-19 Pandemic Treatment Consent Form

I knowingly and willingly consent to have treatment completed during the COVID-19 pandemic at Ideal Pediatrics. I understand the COVID-19 virus has a long incubation period during which carriers of the virus may not show symptoms and still be highly contagious. It is impossible to determine who has it and who does not given the current limits in virus testing.

Fever
Shortness of Breat
Dry Cough
Runny Nose
Sore Throat
Sneezing, Watery Eyes, or Sinus Pain
Headaches, Fatigue or weakness
Loss of sense of taste or smell
* Required field