I understand there is potential risk for exposure to bloodborne pathogens (BBP’s) including Human Immunodeficiency Virus (HIV), Hepatitis B Virus (HBV) and Hepatitis C Virus (HCV), as well as other bacteria, protozoa, viruses and prions during the performance of my volunteer service at Wake Smiles Dental Clinic.
I understand that I am personally responsible for any medical fees and services associated with percutaneous piercing wound, typically set by a needle point, but possibly by other sharp instruments or objects.
I understand that this is a donation of my services and that I am responsible for my own medical care. I also understand that I am not entitled to reimbursement from Raleigh-Wake County Dental Society Community Dental Health Program, INC. (Wake Smiles) for any of my expenditures.