Requesting an Appointment for a Patient
Thank you for choosing Special Anesthesia Services for your sedation needs. Our CRNAs work with over 100 dental offices in Kansas, including many in the Wichita area, providing sedation services to children and adults in the dental office setting.
Please complete the
Appointment Request Form on behalf of your patient. All boxes are required in order to submit the form.
Next Steps
- After the Appointment Request Form has been completed, Special Anesthesia Services will process the information.
- The patient will receive a link through text and/or email to the contact information listed on the previous form. This link will contain the Sedation Paperwork packet for the patient to complete electronically. This information is REQUIRED in order to proceed with the sedation appointment.
- Once the Sedation Paperwork packet has been completed and submitted by the patient or responsible party, a staff member from Special Anesthesia Services will reach out regarding medical clearance and finances/deposit for the upcoming appointment (if needed).
- Once the patient has been cleared for sedation services, our scheduler will reach out to the dental office with available dates and times.
The patient’s appointment will be entered into our system as Pending, until they are medically and financially cleared by Special Anesthesia Services.
If you have any questions or concerns, please contact our office at 316-788-5939. Thank you!