Tier 1 Anesthesia Deposit for surgical time < 2hrs

SEDATION INSTRUCTIONS

• NOTHING to eat within 7hrs of your scheduled appointment.

You may have water/Gatorade/propel/apple juice (clear liquids) up until3hrsbefore your scheduled appointment. NOTHING after that.**Failure to adhere to fasting guidelines will result in the following:(1) Forfeiture of your deposit(2) Payment for the balance of your scheduled anesthesia appointment(3) Cancellation of your surgery.

• If you have Asthma and use an inhaler, please bring it to your appointment.
• Please have your child bathe the morning of the appointment, wear loose fitting clothing, and ideally short sleeve shirt. Also, girls with long hair please put in pig-tails (it is more comfortable for your child and easier to position their head in the chair).
• Do not wear jewelry, contact lenses or makeup to your appointment.
• Please bring a clean blanket. (will be used to cover the patient during surgery).
• Arrive 15min early to your appointment to allow adequate time for your paperwork.
• If you/patient become sick, have a fever over 100.0 degrees or have a cough/sore throat PLEASE contact the dentist as soon as possible to possibly reschedule.
• Parent, on the day of your child's anesthesia and dental procedure, please make arrangements for your other children to be supervised and if possible do not bring them to the office. Your child will need your complete attention on the day of their procedure.
• The child's parent or legal gaurdian must remain at the office during the complete procedure.
• 5% cash discount.
• PAYMENT DUE IN FULL at the time of service.time of service.
• Please call/text me back with any questions.