​How to Book a Case

1. Patient completes IntakeQ forms (health history + financial agreement).
   If additional information (Medical clearance letter, echocardiogram, EKG, etc.) is required, the patient or office must obtain and upload it.

2. Office provides the patient with an estimated anesthesia cost using the Financial Agreement.
   When estimating time, include 60 minutes for induction of anesthesia and recovery time.
   (e.g., 2-hour procedure → quote 3 hours of anesthesia time).

3. Once all forms are submitted, clearance is typically provided within 2–4 business days.

4. After receiving clearance, schedule the case using the Selkirk Anesthesia online calendar.

   • Verify that the selected provider is licensed in your state.

   • Include the procedure name, desired procedure start time, and estimated procedure duration in the booking notes.

   • Patients should arrive 30 minutes before the start time.

   • Allow at least 1 hour before patient arrival for anesthesia setup; in some cases, setup may occur the night prior.

5. The patient will receive a pre-procedure call 1–3 weeks prior.
   Failure to complete this call will result in cancellation.

 

​General Guidelines

• Review all criteria before scheduling to ensure the patient is an appropriate candidate for office-based anesthesia.

• Review all patient instructions with the patient before scheduling.

• Patients must complete the IntakeQ medical questionnaire and receive clearance from Selkirk Anesthesia prior to booking.

• When completing the Financial Agreement, insert the negotiated hourly rate and estimated anesthesia time/charges.

• If a date is not visible on our availability calendar, contact us—additional accommodation may be possible.

Common reasons a patient may not qualify

• BMI > 35

• Uncontrolled hypertension

• Aortic/mitral stenosis or significant valve disease

• Poorly managed heart failure

• Recent MI or stroke

• Pulmonary hypertension

• Recent DVT/PE

• Severe asthma

• Uncontrolled diabetes

• Dialysis-dependent kidney disease

• Personal or family history of malignant hyperthermia

• Uncontrolled seizures

• History of anaphylaxis

• Prior complications with anesthesia

• Known or anticipated difficult airway

• Noncompliance with NPO/fasting guidelines

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Patient Instructions

Patients must follow all instructions or risk cancellation.

• Patient must complete and submit the pre-anesthesia history and evaluation and receive clearance before scheduling.

• Patient will receive a call from their anesthesia provider 1–2 weeks prior. Failure to complete this call may result in cancellation.

• Payment is required before the day of the procedure. No anesthesia will be provided without payment.

• NPO 8 hours before the procedure (no food or drink).

• Take only medications approved by the anesthesia provider, with a small sip of water.

• GLP-1 agonists (Ozempic, etc.) must be held for at least 1 week, and the patient must follow a 24-hour clear liquid diet prior to the procedure.

• Must have a responsible adult to drive home and stay with them overnight.

• No work, alcohol, or machinery use for 24 hours after anesthesia.

A downloadable copy of patient instructions is available under the “Selkirk Dental Anesthe” tab.

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