Practice Name

Specialty

City, State

Phone

FIRST VISIT

Your initial appointment will consist of a consultation explaining your diagnosis and treatment options. Your medical history and treatment plan will be reviewed and an appointment made to provide treatment on another day. Occasionally, in certain situations the surgery may be performed the same day as the consultation.

Please assist us by providing the following information at the time of your consultation:

  • Your surgical referral slip and any X-rays from your
    referring dentist.
  • A list of medications you are presently taking.
  • If you have medical or dental insurance, please bring your card or information. This will save time and allow us to help you process any claims.

A pre-operative consultation and physical examination is necessary for patients undergoing IV anesthesia for surgery.

Please have nothing to eat or drink 8 hours prior to your surgery(after midnight the night before your surgery). You will also need an adult to stay in the office during your treatment and be able to drive you home afterwards.

Please alert the office if you have a medical condition that may be of concern prior to surgery (i.e. diabetes, high blood pressure, artificial heart valves and joints, rheumatic fever, etc.) or if you are currently taking any medication (i.e. heart medications, aspirin, anticoagulant therapy, etc.)

X-Rays

If your dentist or physician has taken x-rays, please ask that they forward them to our office. If there is not enough time, please pick them up and bring them with you to your consultation. If additional films are necessary, they can be taken at our office.

IMPORTANT: All patients under the age of 18 years of age must be accompanied by a parent or guardian at the consultation visit.

Patient Information