Download - New Lousine V. Kirakosian, D.D.S. Look Dental · Patients may require local anesthesia, light to moderate conscious sedation, deep sedation, or general anesthesia for their comfort

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Page 1: New Lousine V. Kirakosian, D.D.S. Look Dental · Patients may require local anesthesia, light to moderate conscious sedation, deep sedation, or general anesthesia for their comfort

INFORMED CONSENT DISCUSSION FOR ANESTHESIA/SEDATION

Lousine V. Kirakosian, D.D.S.

125 E. Glenoaks Blvd., Suite 103• Glendale, CA 91207Tel: (818) 334-3692

Fax: (818) 484-5760Email: [email protected]

www.newlookdentalinc.com

NewLookDental

Page 2: New Lousine V. Kirakosian, D.D.S. Look Dental · Patients may require local anesthesia, light to moderate conscious sedation, deep sedation, or general anesthesia for their comfort

New Look Dental Inc.Lousine V. Kirakosian, D.D.S.

125 E. Glenoaks Blvd., Suite 103• Glendale, CA 91207

Tel: (818) 334-3692Fax: (818) 484-5760 • Email: [email protected]

www.newlookdentalinc.com

Name: Signature: Date: / /20

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