Martn b. Sanders, dds, fadsa, ltd david h. Sanders, dds leslie m. Sanders, dds



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MARTN B. SANDERS, DDS, FADSA, LTD

DAVID H. SANDERS, DDS

LESLIE M. SANDERS, DDS

GENERAL DENTISTRY WITH SEDATION PHONE (630)620-0929

929 S. MAIN ST., STE 100 FAX (630)620-1458

LOMBARD, IL 60148-3387

WWW.SEDATION-DENTISTRY.COM

SEDATION INSTRUCTIONS

IN ORDER TO USE IV SEDATION FOR YOUR DENTAL TREATMENT, WE ASK THAT YOU COMPLY WITH THE FOLLOWING INSTRUCTIONS:



  1. NOTHING TO EAT OR DRINK FOR 6-8 HOURS PRIOR TO YOUR APPOINTMENT.

  2. NO ALCOHOLIC BEVERAGES FOR 24 HOURS PRIOR TO OR AFTER YOUR APPOINTMENT.

  3. NO SMOKING FOR 24 HOURS PRIOR TO OR AFTER YOUR APPOINTMENT.

  4. PLEASE WEAR A LOOSE FITTING (SHORT SLEEVE) SHIRT AT YOUR SEDATION APPOINTMENT.

  5. YOU WILL BE GIVEN A PREMEDICATION PRESCRIPTION FOR YOU TO TAKE ONE HOUR PRIOR TO EACH SEDATION APPOINTMENT.

  6. NO ACRYLIC NAILS OR FINGER NAIL POLISH ON EITHER INDEX FINGER.

WHEN WE USE IV SEDATION, WE ARE ABLE TO COMPLETE MORE DENTISTRY IN EACH APPOINTMENT. IN ORDER TO DO THIS WE SCHEDULE A LARGE BLOCK OF TIME FOR YOU (SOMETIMES BETWEEN 2-3 HOURS). BECAUSE OF THIS TIME COMMITMENT FOR YOUR APPOINTMENT WE HAVE TO:

  1. REQUIRE A DOWN PAYMENT PRIOR TO SCHEDULING A LONG SEDATION.

  2. CHARGE FOR FAILED APPOINTMENTS. THIS FEE VARIES WITH THE LENGTH OF THE APPOINTMENT BUT WILL EQUAL $150.00/HR.

  3. REQUIRE AT LEAST A WEEKS NOTICE FOR ANY CHANGE IN YOUR SEDATION APPOINTMENT.

WITH THE USE OF IV SEDATION WE REGULARILY SEE PATIENTS WHOSE ATTITUDE TOWARDS DENTISTRY BECOMES MUCH MORE POSITIVE ONCE THEY HAVE GONE THROUGH THE EXPERIENCE OF BEING TREATED IN THIS MANNER. IT IS ALSO NORMAL TO HEAR SOME NOISE AND HAVE A SLIGHT AWARENESS OF TREATMENT.

I HAVE READ AND AGREE TO ALL OF THE AFORE MENTIONED



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