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Invoice from Sleep Well Anesthesia

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Robin Blanchard, DNAP, CRNA

Phone: 804 241 8396

Email: [email protected]

Fee schedule prepared for

Virginia Family Dentistry
Danielle McCormack, DDS, MS

2601 Swiftrun Road
Chester, VA 23831

Anesthesia is billed in 15-minute increments.  Below fee outline to is an estimate of your cost. 

Submit Your Payment
  • Anesthesia Setup $350

    • Anesthesia pre-operative assessment/evaluation,
    • patient onboarding,
    • equipment,
    • medications and supplies

  • Anesthesia Service Per Hour $200

    • Anesthesia delivery and monitoring hourly rate

Pre-Treatment Checklist

Things to do before your procedure

Pay your invoice in the customer portal.

Review the Informed Consent form that you will sign in person on the day of your procedure.

Fill out the Medical History Questionnaire.

Acknowledge that you have read the Pre-Anesthesia Instructions.

Acknowledge that you have read the Post-Anesthesia Instructions.

Fill out the HIPAA Privacy Policy Form so that we know how you would like to be contacted.

Post-Treatment Instructions

Things to do after your procedure

ALWAYS DO

Call 911 in the event of an emergency.

DO NOT

You will not be able to drive yourself home. You may not travel home by Taxi, Bus or Uber unaccompanied.

ALWAYS DO

Parents and Guardians: Maintain close supervision of your child for 24 hours to prevent injury.

PLEASE DO

Use special caution when standing, using stairs and walking. Do not perform any strenuous activity or hazardous tasks. This is for your safety.

REMEMBER

If you have and unusual problems or any questions you should call your care team.

Anesthesia Consent

The practice of anesthesia and medicine is not an exact science. The reactions of each person can vary. Even when performed correctly, an anesthetic procedure can be associated with an extreme risk of serious bodily injury or death.

The following is a brief description of the anesthesia which will be available to you.
Please read carefully and discuss in detail with your anesthesia provider.

Moderate Sedation or conscious sedation, commonly known as “twilight sleep”

Intravenous medications will be administered. You should not feel pain, you will be very relaxed, and you will sleep through the procedure. You are monitored closely and continuously during the procedure. You may be easily aroused and will recover quickly.

Patient Statement

Prior to your procedure, your Anesthetic Plan will be discussed with you and you will be asked to sign a form attesting to the following:

  • That you understand that this information is provided so that you can make an informed choice about the type of anesthesia you will be given for this elective surgery.
  • That you understand and give consent to the anesthetic planned, and further understand that your Anesthesia provider may need to change anesthetic choices or certain aspects of the anesthetic plan due to circumstances that may arise during surgery
  • That you have read this from, and understand that you have the opportunity to ask questions and discuss the anesthetic plan with the Nurse Anesthesiologists responsible for my care.