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Noble Pediatric Dental

Gentle care from the start

(513) 514-8440

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Our COVID Policy

We do understand the concern regarding the current COVID-19 status. At Noble Pediatric Dental, we are dedicated to ensuring the health and safety of all patients and staff. It is our goal to provide our patients the ability to receive their dental care, in light of the current outbreak.

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IMPORTANT! The following are required for your appointment:
- Complete our new COVID Consent Form
- Wear a mask to protect yourself and others
- Arrive 10 minutes early
- Regard policy of one adult per family/child
- Sanitize hands at front desk
What to expect with our protocols:
- Your temperature will be checked with our touchless thermometer.
- Our open bay area will be dedicated to one family at any given time to exposure to others.
Consent Form
Patient Name*
First Last
Appointment Date*
MM slash DD slash YYYY
Has the patient or anyone in their household traveled outside of the country or state in the last 30 days?*
- Yes
- No
Has the patient or anyone in the patient’s household, come into contact with anyone who may have tested positive for COVID-19 within the last 30 days?*
- Yes
- No
Has the patient or anyone in the patient’s household recently had, or currently have, a sore throat?*
- Yes
- No
Has the patient or anyone in the patient’s household recently had, or currently have, a cough?*
- Yes
- No
Has the patient or anyone in the patient’s household recently had, or currently have, a fever of more than 100 degrees?*
- Yes
- No
Is the patient or anyone in the patient’s household feeling ill, in any way?*
- Yes
- No
Please call our office to reschedule your appointment.

We do understand the concern regarding the current COVID-19 status. At Noble Pediatric Dental, we are dedicated to ensuring the health and safety of all patients and staff. It is our goal to provide our patients the ability to receive their dental care, in light of the current outbreak.
By signing below, I am acknowledging the information provided is accurate.
Patient/Parent/Guardian Name*
First Last
Today's Date*
MM slash DD slash YYYY
Patient/Parent/Guardian Signature*
CAPTCHA

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We believe it’s important for your child to be comfortable in our office and with our staff. Make your appointment today.

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(513) 514-8440

Fax: (513) 514-8441
2727 Madison Road, Suite 204
Cincinnati, OH 45209

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