Please print these forms and create Patient Packets for each pre-operative appointment. Specific instructions for each form are given below. All patient forms must be signed before a surgery is scheduled and prescriptions are given.
Have patient read and sign this form, then make a photocopy for them to take home.
Have patient take this form home.
Have patient fill out and sign. Scan or take a photo and email to Dr. Johnson for evaluation.
Have patient read and sign.
Have patient read and sign.
Fill out top two lines (disregard SPO2 if office does not have pulse oximeter).
All forms with the exception of the post-operative instructions should be kept as a packet and presented to Dr. Johnson at the surgery appointment.
I had been dreading to have a molar extracted due to an experience many years ago and today, I know I wasted a lot of nervous energy. Dr. Johnson pulled the tooth yesterday using only local anesthesia at my request. He ordered pain pills and I did take one when the numbness was leaving shortly after getting home around noon and have put the rest away-don’t need them. There has not been any actual pain and I feel perfectly normal. My sincere thanks to you, Dr. Johnson and your assistant for an experience that cured my dread and should I ever need another you will hear from me.
- Marty