OFFICE VISIT PROTOCOL in the time of Coronavirus

OFFICE VISIT CHECKLIST FOR DR. LAUREN GREENBERG:

• Sign the Coronavirus consent form. (attached below)
• IF YOU ARE SICK with any of the following DO NOT COME IN. If you have anyone who has tested positive within the last 14 days, do not come in. Symptoms take 2-14 days to manifest.
  • • Cough
      Shortness of breath or difficulty breathing
      Fever
      Chills
      Muscle pain
      Sore throat
      New loss of taste or smell
      GI symptoms: diarrhea, nausea, vomiting.
• Office hours are more limited. We are spacing patients out more. If you have questions, please feel free to email. She is also doing Zoom consultations if you do not need to be seen in person. We are trying to limit the face to face time in an enclosed space, as that is thought to be more dangerous.
• DAY OF VISIT:
  • • -Wait in your car. Make sure we have your cell phone. We will call when to come in.
      -No one else should accompany you (kids, significant other, etc)
      -You need to wear a mask. (Please wear a true mask, not a bandana or scarf if possible) We do not have any masks, (sorry!) as supplies are tight.
      -We will give you hand sanitizer when you enter.
      -Please have any consents or forms filled out before you come in.
      -You will go directly into the treatment room. The room will be cleaned with Clorox wipes between each patient.
      -Your only interaction with Justine will be for payment if necessary.
      -There will be no hand shaking, hugging, or stress balls. (I know! Heartbreaking.)
      -For more information on coronavirus, see Dr. G’s blogs HERE.

Please know if you do not comply with this protocol, you will not be seen. Dr. Greenberg is doing surgeries during this time, and it is paramount we minimize risk to those patients who are healing. We do not expect coronavirus will end anytime soon. If you do not wish to have a visit, please let us know and we will cancel your appointment.

Thank you, and be well.

COVID-19 RISK INFORMED CONSENT

I ______________________ (patient name) understand I am opting for an elective treatment that is not urgent and may not be medically necessary. I also understand the novel coronavirus, COVID-19, has been declared a worldwide pandemic by the World Health Organization. I further understand COVID-19 is extremely contagious and is believed to spread by person-to-person contact; and, as a result, federal and state health agencies recommend social distancing. I recognize that Dr. Lauren Greenberg and her staff are closely monitoring this situation and have put in place reasonable preventative measures aimed to reduce the spread of COVID-19. However, given the nature of the virus, I understand there is an inherent risk of becoming infected with COVID-19 by virtue of proceeding with this elective treatment.

I hereby acknowledge and assume the risk of becoming infected with COVID-19 through this elective treatment, and I give my express permission for Dr. Lauren Greenberg and the staff to proceed with the same.

I understand even if I have been tested for COVID and received a negative test result, the tests in some cases may fail to detect the virus or I may have contracted COVID after the test. I understand if I have a COVID-19 infection, and even if I do not have any symptoms for the same, proceeding with this elective treatment can lead to a higher chance of complication and death.

I understand possible exposure to COVID-19 before/during/after my treatment may result in the following: a positive COVID-19 diagnosis, extended quarantine/self-isolation, additional tests, hospitalization that may require medical therapy, Intensive Care treatment, possible need for intubation/ventilator support, short-term or long-term intubation, other potential complications, and the risk of death. In addition, after my elective treatment may need additional care that may require me to go to an emergency room or a hospital.

I understand that COVID-19 may cause additional risks, some or many of which may not currently be known at this time, in addition to the risks described herein, as well as those risks for the treatment.

I have been given the option to defer my treatment to a later date. However, I understand all the potential risks, including but not limited to the potential short-term and long-term complications related to COVID-19, and I would like to proceed with my desired treatment. I UNDERSTAND THE EXPLANATION AND HAVE NO MORE QUESTIONS AND CONSENT TO THE PROCEDURE.

Patient____________________________________Date/Time_______________

Witness____________________________________Date/Time_______________