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participating providers


To our participating providers, please complete the Sedation Request Form for each patient interested in IV-Sedation.  You can indicate whether they are scheduled or just want more information. We cannot confirm an appointment without a sedation request form.  If there is any extra information our anesthesiologists should know relative to your case please indicate that in the notes section.  

 
 

Patient Registration forms


 

Our financial policy is prepared to help you understand the billing procedures for in-office Sedation Services.


 

Prior to your appointment you will need to review and accept our privacy policy for in-office Sedation Services. 


 

Prior to your appointment you will need to review and accept our HIPPA policy for in-office Sedation Services. 


 

For Pediatric Patients, insurance reimbursement is favorable.  Our office has prepared a guide to help you understand the process and walk you through the steps necessary to obtain the highest level of reimbursement.   


 

Sedation Dentistry is one option for treatment and we want to ensure you are comfortable with this choice of treatment.  For this reason, we require consent from the patient/guardian to the use of IV-Sedation for the completion of dental treatment. 


These instructions must be read and strictly followed before commencing sedation or general anesthesia