Cala Hills Endodontics Demetrick LeCorn, D
Cala Hills Endodontics Demetrick LeCorn, D.M.D., M.S.
2130 SW 22nd Pl #101 Board Certified Endodontist
Ocala, FL 34471 David Kellogg, D.D.S., M.S.
P(352) 291-9360
F(352) 291-9363
Following Root Canal Therapy, it is not uncommon to experience mild discomfort. This can be alleviated by taking over the counter (OTC) pain medications, such as Tylenol and Ibuprofen. We can administer these OTC medications prior to your treatment today. There is no additional charge for this service.
Please check if you are able to take the following:
❑ Tylenol
❑ Ibuprofen (Advil/Motrin)
If not, explain: ___________________________________________________________
If you have taken any or both OTC medications when was the last time you have taken it? ________________________
I, _____________________________________, give consent to the Doctors/Staff of Cala Hills Endodontics, PA to administer oral OTC pain medications to me prior to my dental procedure. I have no medical issues with taking either of the above-mentioned OTC pain medications.
I, _____________________________________, Decline OTC pain medications.
_______________________________________ __________________
Signature Date
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