
| 740 Marne Highway, Suite 103 Moorestown, NJ 08057 phone: 856.638.1234 fax: 856.638.1235 |



| Treatment in the office It is our preference to complete the dental work in our office. If we think it will help, we will use nitrous oxide (laughing gas) to help make your child more relaxed. Treatment in a surgery center Occasionally, when a patient has a substantial amount of dental work that would take multiple appointments to complete in the office, or if a patient's behavior prevents us from safely completing the work in the office, we will bring patients to the Surgical Center of South Jersey to complete all of the dental work under general anesthesia and under the supervision of an anesthesiologist. |
| **If your child is scheduled for surgery, please have the following forms completed. (You should have received these forms from us, but if not, here are copies.) The pediatrician form can only be completed by the pediatrician no more than 30 days before the scheduled surgery. Surgery Center Forms: Form to be filled out by the parent/guardian (2 pages) parent form page 1 parent form page 2 Form to be filled out by the pediatrician (2 pages) pediatrician form page 1 pediatrician form page 2 Surgery Center Information, Consent for Treatment, and Financing Information and Consent Financing (patients with dental insurance) Financing (patients without dental insurance) |
| At Kids First Pediatric Dentistry, our goal is to create a positive dental experience for you and your child. In order to achieve this, we have a couple of treatment options, should your child need to have dental work done. |