Gerald Davis

  
 Gulf Coast 
 SURGICAL CENTER, LLC 
 Conscious Sedation 
 Educational Material and Informed Consent Form 
 The facts in this form will help you learn more about the type of anesthesia your doctor has 
 recommended for your procedure. Please read it carefully.
 Your Health Problem 
 Your doctor has recommended that you have conscious sedation for pain control during your 
 procedure.
 There are many types of anesthesia. 
 Local anesthesia is like the numbing medicine the dentist may use. 
 Minimal sedation involves different types of medicine to make you sleepy. 
 Your nurse will ask you about any allergies before the procedure. 
 First, an IV line will be started.  
 A plastic strip will be placed on one of your fingers and joined to a pulse oximetry machine. 
 The amount of medication is customized for each patient.
 Gerald Davis 
 ID / Visit: 48630 1 
 Gender: F 
 DOB: 1993/06/04 
 Age: 82 
 Phys: Dr Kenneth Williams
 dos: 2014/16/10 
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