Download Patient Consent Form

1. Do not eat or drink anything after midnight.
2. Take your regularly scheduled morning heart and BP meds on the day of surgery with a small sip of water.
3. Bring all of your medications with you.
4. Stop any over the counter supplements and herbals 2 WEEKS before surgery.
5. Stop any diet pills 2 WEEKS before surgery.
6. Stop smoking at least 24 hrs. prior to surgery. Stopping for six to eight weeks before surgery is ideal.
7. Remove contact lenses and removable dental appliances before entering the operating room.
8. If you are a chronic pain patient, you may take your regularly scheduled morning dose of pain medications on the day of surgery with a small sip of water.  Please let your anesthesia provider know if you are using a fentanyl patch.

1. Your medical problems
2. List of medications
3. If you smoke or drink alcohol and how much
4. Drug allergies
5. Any previous problems you have had with anesthesia or any family history of problems with anesthesia.