Patient Instructions

If you need to cancel or reschedule your procedure for any reason, it is your responsibility to notify us at least 48 hours in advance to avoid a cancellation fee. Our cancellation fee is $100 as stated in the New Patient Handbook. We require all procedure patients to arrive 30 minutes prior to their appointment time. If you arrive past your appointment time, we reserve the right to reschedule your procedure and you will be charged a cancellation fee. Your arrival time presented above includes the 30 minutes before your appointment time slot.

  • IV Sedation – In Office (Anesthesia) Do not eat/drink for 8 hours before your procedure, including cough drops, candy, gum and tobacco. You must have a driver
  • Oral Sedation (Valium) – You may have a small meal up to four hours prior to your procedure. You must have a driver.
  • No Sedation – No dietary restrictions. Please eat a light meal prior to your procedure to avoid nausea.

Medication Restrictions

If you are diabetic, please check your blood sugar the morning of the procedure. If your blood sugar low you may drink up to 6 oz of clear liquids up to 4 hours before your procedure if you are receiving IV or Oral sedation. (See the back of this form for approved liquids) If you are not receiving sedation you may drink clear liquids up to the time of the procedure. If your blood sugar is above 250 please refer to the back of this form under medication instructions.

If you are currently prescribed a blood thinning medication, please inform our office so that we may obtain consent to discontinue your prescribing physician. We will notify you as to when you need to stop this medication. (ONLY discontinue blood thinning medication after being notified by our office)

If you are prescribed or begin taking an antibiotic prior to your procedure, you must complete the entire course of antibiotics before your procedure. You must have no fever or infection. Please call and inform the office if you are prescribed or begin taking antibiotics.

Medication Instructions

  • Please take ALL blood pressure, heart, stomach/acid reflux and breathing medications (inhalers) on the morning of your procedure with a sip of water. You may bring your pain medicine with you to take after your procedure if needed.
  • If you are insulin dependent and your morning blood sugar is greater than 250 please take ½ dose of morning insulin. If you are not insulin dependent and your morning blood sugar is greater than 250 please contact our office at (205) 208–9001 for instruction.
  • Regular medications will not be discussed at your procedure appointment. You may make a clinic appointment to discuss any concerns with your prescribed medications.

Approved Liquids

If you are diabetic and your blood sugar is low, you may consume no more than 6 oz of the liquids listed below, up to 4 hours before your procedure. Anything not listed below should be avoided.

  • Plain Water
  • Tea or Coffee (without milk, cream, sugar or any other additives)
  • Clear, fat-free broth
  • Fruit juices without pulp (examples include apple juice and cranberry juice, No Orange Juice)
  • Clear soda (examples include Ginger ale or Sprite)

Important Precautions

  • If you have a spinal cord stimulator, please inform your medical assistant at the time of procedure and ensure the device is turned off prior to the procedure.
  • If you are hospitalized within 7 days of your procedure, please call our office.
  • If you experience chest pain, shortness of breath, or a cardiac abnormality within 7 days of your procedure please call our office and follow up with your cardiologist or primary care physician.