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Mobile dental anesthesia providers servicing Boulder, Denver, Fort Collins, Colorado Springs and everything in between.

New Patient Registration

Financial Agreement

Registro por Pacientes Nuevos

Click the box above to complete the medical history prior to anesthesia

Haga clic en el cuadro de arriba para completar el historial médico antes de la anestesia

All non-medicaid patients must sign the financial agreement

ANESTHESIA FORMS

Click to Download

Office Staff - Please have patients sign the consent and complete the patient registration/medical history. These can be completed by printing the following documents (#1 and #2) or by having the patient click on the patient registration buttons at the top of the page. Thank you!

1. CONSENT

POST-OPERATIVE INSTRUCTIONS

2. PATIENT REGISTRATION/MEDICAL HISTORY

PRE-OPERATIVE QUESTIONS FOR PARENTS

PEDIATRIC ANESTHESIA OVERVIEW

En Español

STATEMENT OF ANESTHESIA SERVICES

ANESTHESIA FORMS

Click to Download

Office Staff - Please have patients complete patient registration/medical history and sign the consent. These can be completed by printing the following documents (#1 and #2) or by having the patient click on the patient registration buttons at the top of the page. Also please have the patient complete the COVID-19 forms as well. Thank you!

POST-OPERATIVE INSTRUCTIONS

Download (Yancey)

1. PATIENT REGISTRATION/MEDICAL HISTORY

2. CONSENT

PRE-OPERATIVE QUESTIONS FOR PARENTS

PEDIATRIC ANESTHESIA OVERVIEW

En Español

STATEMENT OF ANESTHESIA SERVICES

Download (Yancey)

Download (Smith)

LETTER OF NECESSITY TEMPLATE

ORAL SURGERY POST-OP CARE

Download (Smith)