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Dr. Diederik W. Millenaar, Inc.
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Certified Specialist in Pediatric Dentistry
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2020-06-25T14:36:44+00:00
Forms
Useful information for patients and referring offices
FORMS
– COQUITLAM PEDIATRIC DENTIST
FORMS
Useful information for patients and referring offices.
Click on the
BLUE
links below to download form.
COVID-19 SAFETY
Covid-19 Patient Screening and Consent Form
FOR REFERRING OFFICES
Patient Referral Form
TREATMENT CONSENT FORMS
Dental Treatment Consent Form
Minimal Sedation Consent Form
DENTAL ORAL HEALTH TIPS
Infant Oral Health Tips
Preschool & School-Aged Oral Health Tips
PRE-SEDATION INFO
Pre-Sedation Instructions for Nozinan
Pre-Sedation Instructions for Midazolam
Pre-Sedation Instructions for Nitrous Oxide
POST-SEDATION INFO
Post-Sedation Instructions for Nozinan or Midazolam
Post Extraction Care Info
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