(414) 301-5958

(414) 301-4137

Mon, Tue, Wed, Thu 9 AM to 2 PM by appointment/Closed: Fri, Sat, Sun

Referring Doctors

Referring Doctors

Please evaluate for the following treatment:


Please remove teeth marked:

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
RIGHT 32
31
30
29
28
27
26
25
24
23
22
21
20
19
18
17
LEFT
A
B
C
D
E
F
G
H
I
J
RIGHT T
S
R
Q
P
O
N
M
L
K
LEFT

INSTRUCTIONS FOR PATIENTS

  • Please call (414) 301-5958 to schedule an appointment or consultation.
  • If you take blood thinners, a heart condition, diabetes, or have had heart valve replacement or joint replacement surgery, please contact us prior to your appointment for special instructions.
  • Please bring to your appointment or send by email to info@greenfieldoralsurgery.com
    • this sheet
    • any x-rays your dentist has given you
    •  a list of all your medications and dosages you are taking
    • your medical and dental insurance cards
  • Minors (under 18) must be accompanied by parent or legal guardian
  • If you are considering intravenous sedation
    • do not eat or drink anything (including water or coffee) for at least 8 hours prior to surgery
    • the night before eat a light meal, and consume no alcohol
    • take your normal daily medications at the same time with a sip of water
    • bring someone with you to drive you home
    • wear loose clothing, preferably short sleeves
    • no strenuous exercise the day of surgery

INSURANCE AND PAYMENT

If you have insurance, it is your responsibility to call your insurance company to verify your coverage and deductible. You must bring a photo ID and your insurance cards with you. As a courtesy, we will file insurance for you; however, the financial obligation for the treatment we provide is your responsibility.

  • We offer CareCredit, you can apply ahead of time or at our office.
  • Cash, checks, and all major credit cards are accepted.