NEW Moshiri Orthodontics Patient Forms

After you submit the forms, check your email for a copy of the signed docs which we will also save in your digital patient files.  Thank you!

Moshiri Orthodontics NEW Patient Updates

In order for us to make sure you are up to date and understand our new in-office protocols and safety measures, we have these important updates for you to review and acknowledge your consent. We appreciate your patience as we work diligently to get our practice open to serve you.

  • Policies and Procedures at Moshiri Orthodontics for the COVID-19 Era

  • If different from Patient Name
    1. A SUPPLEMENTAL WELLNESS QUESTIONNAIRE must be filled out and signed PRIOR to each and every appointment for the foreseeable future; otherwise, we will not be able to treat you or your family member within our facility. We will email this to you prior to each appointment. A copy may also be found on our website under COVID-19 resources.

    2. We are going to practice social distancing as much as we can for the health and safety of our patients. This means that our waiting room will have very limited capacity. Please stay in your car, and text us at (314) 200-5569‬ when you have arrived. If the patient is a minor, we will have “runners” who will physically come out to your car to escort your child to and from the appointment. Please use the east entrance of the building to park, and tell our office staff the patient’s name, and make and model of your car, when you have arrived. 

    3. We kindly ask that you or your child wear their own mask into and out of the building. Wearing a mask greatly reduces transmission of the disease for you and those around you. Patients will be asked to wash their hands immediately upon entry, as well.

    4. Please also brush your teeth at home prior to your visit, as our tooth brushing station is closed indefinitely. We will have all patients rinse with a specifically formulated mouth rinse prior to each visit as well to decrease viral/bacterial counts in the saliva prior to treatment.

    5. We will be taking temperatures of all our patients prior to their appointment; if we detect a temperature higher than 100.4 degrees, we will have to reschedule the appointment.

    6. If for any reason a guardian must accompany a patient back to the clinic, they will need to undergo screening in our triage area, as well.