Your First Visit

Instructions to Patient

  1. Please bring this form, x-rays, and ill insurance information with you to your appointment.
  2. On the day of surgery, do not eat or drink anything for 6 hours before your appointment if IV (intravenous medications) or general anesthesia are to be used, and arrange for a driver to come with you and assist you home.
  3. Any unmarried patient under 18 years of age must be accompanied by a parent or guardian at the time of surgery.


Preparation for Oral Surgery

Thank you for visiting our office. Although most of the information given here has been discussed with you, this may provide additional information or serve as a reminder.

*Please park in the 1 hour visitor parking when you arrive for your appointment.

*Only the patient will be allowed in the operating room during surgery.

*If any form of sedation is to be administered, please do not eat or drink anything 6 hours prior to your appointment. This will minimize the anesthetic risk and reduce the chance of stomach upset or nausea. Also, be sure that you are accompanied by a responsible person who can drive you home following the procedures. We request that the parent/driver remain at the office during the surgical procedure. Please wear a short-sleeved shirt and empty your bladder prior to coming to the office.

* Payment of fees has previously been discussed with you. The fee for services rendered includes all follow-up visits after surgery; however, if additional procedures are necessary to rectify your situation you may be charged for those services. We will file your insurance claim for you; however, you are ultimately responsible for your bill.

*If you are unable to keep your surgery appointment, please notify us within 48 hours (sooner if possible) or you will be charged for the appointment.

*There will be a 43% collection charge for any account that is turned over to a collection agency (>90 days past due).