YOUR OBLIGATIONS IF IV ANESTHESIA IS USED Because anesthetic medications cause prolonged drowsiness, you MUST be accompanied by a responsible adult to drive you home and STAY with you until you are recovered sufficiently to care for yourself. This may be up to 24 hours. A responsible adult must accompany the patient and REMAIN IN THE WAITING ROOM FOR THE ENTIRE TIME of the procedure. This person must be able to drive since the patient will be unable to drive for at least 24 hours after the anesthesia or sedation. Watch for Drowsiness. During recovery time (24 hours) you should not drive, operate complicated machinery or devices, or make important decisions such as signing documents, etc. Do not drink alcohol. You must have a completely empty stomach. HAVE NOTHING TO EATOR DRINK FOR SIX (6) HOURS PRIOR TO YOUR ANESTHETIC. TO DO OTHERWISE MAY BE LIFE THREATENING. Take your regular medications, the morning of surgery with sips of water only. Loose clothes should be worn to facilitate the starting of an intravenous and the placement of monitoring equipment. Flat comfortable shoes should also be worn. Because your blood pressure will be monitored, you should wear a short sleeve shirt. Do not wear jewelry, watches, make-up, finger nail polish, or contact lenses. If you have a severe cold, sore throat or sinus infection with infection with excessive drainage, sedation medications can not be administered. Please call the office if any of these symptoms develop prior to your scheduled appointment. While taking antibiotics, Birth Control Pills, may become ineffective. Extra precautions should be taken while you are on antibiotics. Fill any prescriptions prior to your appointment. It has been explained to me that in the course of the procedure unforeseen conditions may be revealed which will necessitate extension of the original procedure, a different procedure from those set forth above, or abandonment of the procedure entirely. In such an event, I authorize my doctor and his staff to perform such procedures as are necessary and desirable in the exercise of professional judgment to complete my surgery. It has been explained to me that a perfect result is not and cannot be guaranteed or warranted. Initials
YOUR OBLIGATIONS IF IV ANESTHESIA IS USED Because anesthetic medications cause prolonged drowsiness, you MUST be accompanied by a responsible adult to drive you home and STAY with you until you are recovered sufficiently to care for yourself. This may be up to 24 hours. A responsible adult must accompany the patient and REMAIN IN THE WAITING ROOM FOR THE ENTIRE TIME of the procedure. This person must be able to drive since the patient will be unable to drive for at least 24 hours after the anesthesia or sedation. Watch for Drowsiness. During recovery time (24 hours) you should not drive, operate complicated machinery or devices, or make important decisions such as signing documents, etc. Do not drink alcohol. You must have a completely empty stomach. HAVE NOTHING TO EATOR DRINK FOR SIX (6) HOURS PRIOR TO YOUR ANESTHETIC. TO DO OTHERWISE MAY BE LIFE THREATENING. Take your regular medications, the morning of surgery with sips of water only. Loose clothes should be worn to facilitate the starting of an intravenous and the placement of monitoring equipment. Flat comfortable shoes should also be worn. Because your blood pressure will be monitored, you should wear a short sleeve shirt. Do not wear jewelry, watches, make-up, finger nail polish, or contact lenses. If you have a severe cold, sore throat or sinus infection with infection with excessive drainage, sedation medications can not be administered. Please call the office if any of these symptoms develop prior to your scheduled appointment. While taking antibiotics, Birth Control Pills, may become ineffective. Extra precautions should be taken while you are on antibiotics. Fill any prescriptions prior to your appointment. It has been explained to me that in the course of the procedure unforeseen conditions may be revealed which will necessitate extension of the original procedure, a different procedure from those set forth above, or abandonment of the procedure entirely. In such an event, I authorize my doctor and his staff to perform such procedures as are necessary and desirable in the exercise of professional judgment to complete my surgery. It has been explained to me that a perfect result is not and cannot be guaranteed or warranted. Initials
dental_implant_consent.docx