This sheet may be printed, filled out and brought during
your first appointment. Please bring this form with you to the office; do not send it. Sending this
form does not in any establish or indicate a doctor-patient relationship. A doctor-patient
relationship has not been established until you have seen Dr. Becker in the office.
This is a routine questionnaire of the type that new patients usually fill out
for the doctor's knowledge. If you do not have a printer, please notify the office (856-589-NOSE)
and request that a copy be mailed or FAX'd to you. Click
Here to view this form.
Note that, due to varying computers (PC/Mac), web browsers and printers, some may
experience difficulty printing
this document. If content runs off to the right, you may adjust your default font and/or margins
on your browser (10 point is recommended size). If you still have problems, please request that
we mail you a copy (856-589-NOSE).
Patient Instructions
Some general information for all patients undergoing surgery is found here:
Whenever undergoing a procedure under sedation anesthesia or general anesthesia, you
must not eat or drink anything after midnight the night before surgery.
On the day of surgery, it is preferable that you wear clothes that button up the front rather
than clothes that must be pulled over your head, such as sweaters, t-shirts, etc., because
button-up shirts are easier to put on and off after facial surgery. Someone must be with
you to take you home after any procedure in which sedation or general anesthesia is used.
Remember, DO NOT TAKE ASPIRIN or other similar products (ex. Motrin, Advil,
Excedrin, Ibuprofen, Naprosyn, etc.) for 2 weeks prior to surgery. This is important
because these products can result in increased bleeding during surgery. For headaches
and other pain during this time, you may take Tylenol.
Some herbal products, such as Gingko biloba, also may increase bleeding during surgery.
Please notify your surgeon during your office visit about any herbal products you take so
we may advise you about whether you may use them in the weeks prior to surgery.
We have included specific instructions for each procedure (example Facelift, Laser
Resurfacing, Rhinoplasty, etc.) under that procedure, because instructions do vary. We
hope that this information answers your questions; of course, if you have further
questions, please
contact us.
