Information Must Be Filled Out
Instructions for patients :
1. Patients receiving oral sedation must have absolutely nothing
to eat or drink 4 hours before appointment time.
2. Minors must be accompanied by a parent or legal guardian, or
must have a written consent for treatment and anesthesia.
3. Please bring this card and, if available, recent X-rays of
the areas involved.
4. Please give us at least 24 hours notice if you are unable to
keep this appointment.
Please fill all the fields.