As the coronavirus (COVID-19) continues to spread, [insert practice name] wants to ensure that you are aware of what steps we are taking to protect both you as an employee as well as our patients.
In order to prevent the spread of COVID-19, please ensure that you follow the guidance listed below:
- Cover your mouth and nose with a tissue or your sleeve (not your hands) when you cough or sneeze;
- Throw all used tissues in the trash right away and wash your hands immediately after handling used tissues;
- Wash your hands immediately before and after the treatment of each patient;
- Avoid touching your eyes, nose or mouth;
- Avoid close contact with people who are sick; and
- Clean and disinfect frequently touched objects and surfaces, such as your keyboard or mouse, countertops and other surfaces in the office and the operatories, including treatment chair arms, etc. with a disinfectant provided by the Practice;
- Follow all other safety protocols, as discussed below, to reduce the risk of infection of the staff and patients from the coronavirus.
In addition, the Practice will take all reasonable means, within the limits of what is available to it, to continue to follow all federal, state and local regulations including, but not limited to, the Center for Disease Control (“CDC”) and Occupational Safety and Health Administration (“OSHA”) guidelines to protect employees and patients during this time.
To the extent that they are available, the Practice will continue to provide staff with personal protective equipment (e.g. masks, gloves and safety glasses) (PPE).
I acknowledge that I will use this PPE in compliance with all infection control guidelines for their use to reduce the risk of infection of staff and patients from the coronavirus.
I acknowledge that the Practice has provided me with the CDC and American Dental Association (“ADA”) guidelines, for infection control of the coronavirus, from the CDC and ADA websites; and that I will follow these guidelines in my providing emergency dental care for any Practice patients.
I acknowledge that the Practice can immediately send me home and take other disciplinary action, up to and including immediate termination, for: (1) any failure to use PPE in accordance with all the infection control guidelines for their use; and (2) any violations of Practice, CDC and/or ADA guidelines for coronavirus infection control in my providing emergency dental care for Practice patients.
I understand that the symptoms listed below are representative of COVID-19:
- Fever
- Dry Cough
- Shortness of Breath
- Temperature
- Persistent pain or pressure in the chest
- Bluish lips or face