Pre-Op Consult a) Review with the Inmate the potential risk that could be associated with the planned surgical treatment. Check the boxes for all areas of potential risk that may apply. In addition, circle any of the listed nerves in which there is a potential for injury. Additional notes can be made in the area of the listed risk factor, as needed. If the “other” box is checked, place the information reviewed in the notes segment below, with a notation that this information was reviewed prior to the surgery.
Pre-Op Consult a) Review with the Inmate, the potential risk that could be associated with the planned endodontic procedure, as well as the needs for additional treatment. Additional hand written notes can be made in the area of the listed risk factor or recommended treatment, as needed. If the “other” box is checked, place the information reviewed in the notes section below, with a notation that this information was reviewed prior to the endodontic procedure.
