🏵 COVID-19 Update:
We want you and your loved ones to be safe during this unprecedented pandemic, so please cooperate in our efforts as we comply with the CDC and NYS guidelines. You will get a Covid test as required by the individual facilities.
🚫 DO NOT come if you are on antibiotics for any reason. The course of antibiotics should be done by the time of your appointment.
🚫 DO NOT come if you are unwell, have a fever, or cough.
🚫 DO NOT bring unnecessary items to your visit. Leave these at home or in the car.
🚫 DO NOT congregate near the reception desk. Maintain 6 feet distance from others.
🚫 DO NOT bring extra family members. Only patients are allowed inside.
✅ DO wear a mask and gloves. You will not be allowed to enter the facility without a mask.
✅ DO bring proof of vaccination or recent negative Covid test.
✅ DO call the office when you have arrived and remain in the car or outside.
✅ DO wear a mask. You will NOT be allowed to enter the facility without a mask.
✅ DO wash your hands or use provided hand sanitizer upon entering the facility.
✅ DO wash your hands or use provided hand sanitizer frequently
✅ We are all in this together, so please cooperate – Thank you
I UNDERSTAND THESE INSTRUCTIONS ARE MY PRE-PROCEDURE MEDICAL RESPONSIBILITIES. PLEASE BRING THIS SIGNED FORM BACK TO THE OFFICE ON THE DAY OF YOUR PROCEDURE.
CALL THE OFFICE 24 HOURS BEFORE APPOINTMENT TIME TO RECONFIRM APPOINTMENT, or YOU MAY BE CANCELLED
1. REMEMBER- REFERRALS / INSURANCE AUTHORIZATIONS ARE YOUR RESPONSIBILITY
2. Procedure day: Expect about 2-3 hours from when your doctor re-evaluates you on the day of the procedure to when you are cleared to leave the office. As New Yorkers’ we hate waiting but remember that when you have your procedure, we give you our undivided attention, just as we do for the patients ahead of you. Patients who need to leave earlier for a medical reason, i.e., kidney failure, dialysis, and severe diabetes, are given morning slots. Thank you for your patience.
Before Your Procedure Instructions– GENERAL
✅ Do not eat anything (including candy, gum, mints) 7 (seven) hours before your appointment.
✅ Clear liquids are allowed (apple juice, water, tea, no milk ) 3 hours before the procedure.
✅ A Responsible adult must accompany you home after the procedure. (Unless the procedure is done at ASC Midtown where the car service driver can double as your escort home) .
✅ Do not operate machinery, drive a car, make legal, financial, medical decisions, etc. x 24 hours
✅ Call the office if you cannot comply with these requirements. You will be rescheduled.
✅ Dress Code: Sweatpants, Short sleeve shirt, sneakers. NO open-toe shoes. Hair ties.
✅ Shower and shampoo the morning before the procedure but do not use any lotions/cream afterward.
✅ For female patients younger than 50: a urine pregnancy test will be required with rare exceptions ( hysterectomy, early menopause, etc)
Follow the directions below based on your current condition.
🔲 HYPERTENSION (high blood pressure)
- Take your BP medication at usual time. Failure to do so may result in higher blood pressure during the procedure than would be desired. If you feel your blood pressure is not controlled for any reason, please get in touch with your physician.
- The injected steroid can cause temporary retention of fluid.
🔲 DIABETICS (high blood sugar). See below.
- INFORM the staff when they schedule their appointment to get an early appointment.
- Bring juice or a light snack containing sugar you can eat or drink after the procedure.
- TEST your blood sugar before you come to the office and bring results.
- Do Not take your usual oral diabetes pills until AFTER the procedure.
- BRING your insulin with you to the office. Bring your blood sugar testing supplies.
- Insulin: Take half 1/2 the usual dose of short-acting insulin. Do Not take long-acting insulin.
- BRING candy or a snack with you if your blood sugar is low. Discuss with the doctor.
- Blood sugar and blood pressure may increase with steroids. This is temporary. Check your sugars regularly after the procedure, and call the office if you have any concerns.
- My blood glucose today before the procedure is ______________
- Patients with airway disease, including asthma, bronchitis, emphysema, etc., should take all their usual medications and inhalers before coming to the office. Inform your doctor if you have ever been hospitalized because of asthma or had a breathing tube.
- Bring your inhaler with you and take two puffs of your inhaler just before your procedure.
🔲 BLOOD THINNERS. SPEAK TO YOUR PHYSICIAN ABOUT THIS!!! Most procedures cannot be done while you are taking blood thinner meds.
MEDICATION: see below to determine when to STOP before PROCEDURE.
- Patients taking blood-thinning medication such as Plavix or Coumadin (not aspirin) should immediately inform their physician and staff.
- You may continue aspirin 81 mg, Motrin, and other anti-inflammatory medications.
- These procedures cannot be done while you are taking blood-thinning medications.
- A written note from your cardiologist is required.
- I stopped my blood thinning medication as directed on date ______________
-COMMON BLOOD THINNERS – timing to stop pre-injection. Discuss with your surgeon and cardiologist.
Coumadin x 5 days
Plavix (clopidogrel) x 7 days
Eliquis (apixaban) x 2 days
Effient (prasugrel) x 7 days
Xarelto (rivaroxaban) x 2 days
Pradaxa (dabigatran) x 2-5 days
Aggrenox x 7 days
Lovenox (enoxaparin) x 12-24 hours
Pletal (cilostazol) x 3 days