South West Dental Anesthesia

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You are here: Home / Dental Care for Special Needs Children: Forms & Instructions

Dental Care for Special Needs Children: Forms & Instructions

We hope you find this page helpful in setting up dental care for special needs children. You will find forms and instructions you will need either for yourself or to complete for us. You can download and print them in the privacy of your home.

First, we need you to complete a patient information form. This is an online form that you complete and submit directly to our office. Or we always have forms available here at our office.
Patient Information – Child with special needs (ENGLISH) (SPANISH) See note at bottom of page.

Next you will need your anesthesia instructions:
Anesthesia instructions – Child with special needs (ENGLISH) (SPANISH) – Please print and read this form carefully
For more detailed instructions: (ENGLISH)

Next you need to complete the anesthesia consent form:
Consent for Anesthesia – Child with special needs (ENGLISH) (SPANISH)

Finally there are some post-anesthesia instructions you need to follow:
Post Anesthesia Care Instructions – Child with special needs (ENGLISH) (SPANISH)
Please Give Us Your Feedback (ENGLISH) (SPANISH)

NOTE: Some of the forms are submittable online, and some you will need Adobe PDF Reader in order to read and/or download the forms. It’s free. Just (CLICK HERE) and when given a choice between run and save, click run. That will install the application on your computer and you will be ready to read and download.

Your Doctor

Anthony Caputo, DDS, MA, FACD, FICD, DADBA, DNDBA

Serving You in Our Office

Paula Guerra - Patient Care Coordinator

2015 Patients’ Choice Award

Top Dentistry Clinics in Tucson, AZ
Dr. Anthony C. Caputo, DDS is ranked in the Top Dentistry offices in Tucson, 2015.
Verified by https://opencare.com

For More Information

Southwest Dental Anesthesia Services
5255 N Salida Del Sol Dr
Tucson, AZ 85718

520.571.7951

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