Questionnaire to prepare for surgery
To best prepare for your child’s procedure, we ask you to fill out a short questionnaire. This information will give us a better idea of the medical background and any concerns that may be important for treatment. Below is all the information on how to download, complete and upload this questionnaire.
Why this questionnaire?
This questionnaire helps us to:
- Surveying your child's health status.
- Know in advance any allergies, medications or other medical concerns.
- Making treatment as safe and efficient as possible.
We thank you in advance for your cooperation. In this way, together we can ensure a smooth and quality operation.

Upload the completed document
After filling out, you can safely and easily upload the document here. Press the button below or drag the file into the upload field.
Once we receive your questionnaire, we will send you a confirmation email.
Upload questionnaire

Download our information brochure
Want to know all about anesthesia for children? In our brochure you will find all the information about treatment, preparation and frequently asked questions. Download the brochure and learn how we ensure a relaxing dental visit for your child.