Phone: (813) 684 - 6509
Fax: (813) 685 - 9447

Downloads

We have provided the documents below for your use. Please feel free to print and fill them out before your office visit.

Create My Patient Chart

Please download and complete the forms below before you come to your appointment. You'll notice that the "Create Your Chart" section is broken down into two categories: Endodontic Services and Anesthesia Services. If you're not using our Anesthesia services, then you don't need to fill out those forms. We hope you find these forms will save you time when you come in for your appointment making your visit a very smooth experience. We look forward to seeing you, soon!

For Endodontic Services (1-5)

For Anesthesia Patients (1 - 3)

 TitleModified DateSize 
1- Sedation Medical History10/12/20107.30 KBDownload
2- Informed Oral Consc Sed10/12/201075.45 KBDownload
3- Consent for IV Endo Anesthesia10/12/201093.82 KBDownload

Endodontics

 TitleModified DateSize 
How To Get Ready9/26/201150.68 KBDownload
Post Operative RCT Information9/26/201158.17 KBDownload
Home Care Following Endodontic Surgery9/26/201170.06 KBDownload

Anesthesia

Miscellaneous

 TitleModified DateSize 
Body Mass Index Chart10/12/2010250.94 KBDownload
Diabetes Symptoms7/14/201011.08 KBDownload
Glucose Ranges7/14/201010.16 KBDownload
Normal blood values7/14/201048.73 KBDownload
Office Map7/14/2010216.00 KBDownload
Referral Slip7/14/201022.70 KBDownload
What to do with a knocked7/14/201069.83 KBDownload
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