GA Appointment Structure and Forms
What This Module Covers
This reading walks you through the structure of a GA paperwork appointment from the first minute to the last, including what forms must be completed for each patient type and what happens after GA day.
The Sixty-Minute GA Paperwork Appointment
Every GA paperwork appointment follows the same four-phase structure. This is not a casual conversation. It is a structured clinical appointment with a specific sequence designed to ensure nothing is missed.
Phase One: Introduction (Ten Minutes)
Begin by confirming the guardian relationship. Ask who is present and verify they have legal authority to consent to the child’s treatment. This is not a formality. Without proper guardian consent, the surgery cannot proceed.
Acknowledge the family’s anxiety. Many parents are nervous about anesthesia. Start with empathy before launching into logistics. Something like: “I understand this feels like a big step. Today we are walking you mentally through the day. The goal is that there are no surprises.”
Explain the purpose of today’s appointment. You are here to educate the family, complete all necessary paperwork, review the child’s medical history, and set deadlines. Clarify that today is about education and administration, not treatment.
Phase Two: Fasting Education (Critical Safety Content)
This is the most safety-critical part of the entire appointment. Fasting violations cause surgery cancellations and can endanger lives.
The child must have nothing to eat or drink for a minimum of five hours before the procedure. This means nothing. Not food. Not water. Not milk. Not juice. Not even a sip. If the child eats or drinks anything within the fasting window, the surgery will be cancelled.
Explain this with absolute clarity. Do not soften the language. Do not say “try not to eat.” Say: “Nothing by mouth for five hours. Not even water. If your child has anything to eat or drink, the surgery will be cancelled because it is not safe to proceed.”
Explain why. When a patient goes under general anesthesia, the muscles that normally prevent stomach contents from entering the lungs relax. If there is food or liquid in the stomach, it can be aspirated into the lungs. This is a life-threatening emergency called aspiration pneumonia.
Explain the timing reality. The arrival time at the facility may be much earlier than the actual surgery time. If the family is told to arrive at seven in the morning but surgery is at nine, the fasting window starts from the surgery time and works backward. Help them calculate exactly when their child must stop eating and drinking.
After explaining, use the teach-back method. Ask the parent to repeat the fasting instructions back to you. Do not just ask “Do you understand?” Ask them to explain what they will do if the child wakes up crying and asks for water in the early morning.
Document: “Fasting instructions reviewed and verbalized back by parent.”
Phase Three: What Happens on GA Day
Walk the family through what they will experience on the day of surgery. Cover these topics in order:
Induction method. Explain that the child will receive anesthesia either through a mask placed over their face or through an IV line. Younger children often start with mask induction. The anesthesiologist makes this decision.
Parent presence during induction. At some facilities, one parent may be present while the child goes to sleep. Explain the protocol for your facility. If parents can be present, explain what they will see so they are not alarmed.
Dentist reassessment and x-rays. Once the child is under anesthesia, Dr. Tsang will take fresh x-rays and reassess the treatment plan. This may reveal additional cavities not visible during the initial consultation. Explain clearly that the final treatment may differ from the estimate.
Possible treatment changes. Because of the updated x-rays, additional work may be needed. The family should understand this before surgery day so it does not come as a surprise.
Recovery timeline. The total time at the facility is approximately five to six hours from arrival to discharge. The child will be groggy and may be irritable after waking up. This is normal.
Post-operative pain expectations. Explain what discomfort is normal and what warrants a call to the office.
Ask directly: “Do you have concerns about anesthesia itself?” If the parent expresses high anxiety, consider recommending a pre-anesthesia consultation with the anesthesiologist.
Phase Four: Paperwork Completion
Complete all required forms during this appointment. Do not send families home with blank forms to complete later. Forms completed at home often come back incomplete or incorrect.
Required Forms: All GA Patients
Every child going for General Anesthesia requires the following eight items regardless of facility:
| Item | Purpose |
|---|---|
| Dr. Tsang Consent | Authorization for the dental treatment under GA |
| Facility Consent (ARH or AFD) | Authorization for the anesthesia and facility use |
| Health and Physical form | Medical history and physical assessment for the anesthesiologist |
| Pre-operative instructions | Written fasting and preparation instructions for the family |
| Post-operative instructions | Written recovery and aftercare instructions |
| GA Checklist | Internal tracking document ensuring all steps are completed |
| Admin fee 05202 collected | Administrative fee for GA coordination |
| Insurance preauthorization | Approval from insurance before treatment proceeds |
Additional Forms: ARH Package
When the child is going to Abbotsford Regional Hospital, these additional Fraser Health documents are required:
| Form | Purpose |
|---|---|
| Fraser Health Pre-Surgical Questionnaire | Hospital-specific medical screening |
| Fraser Health Consent | Hospital consent for anesthesia services |
| Operating Room booking form | Surgical scheduling documentation |
| Lab form (if required) | Pre-operative blood work or testing orders |
Additional Forms: AFD Package
When the child is going to Anesthesia for Dentistry, these additional documents are required:
| Form | Purpose |
|---|---|
| AFD Consent | Facility-specific consent for outpatient GA services |
| Health and Physical (reviewed for BMI) | H&P with particular attention to BMI documentation |
| Insurance triage form (if MSSH) | Required for private facility billing under MSSH coverage |
Post-GA Flow: What Happens After Surgery
Your awareness of the post-GA process matters even though some steps are handled by other team members.
Claim co-submission. The GA facility fee must be submitted on the same claim as the dental treatment. This is an insurance requirement. If the GA fee is submitted separately, it may be denied.
Signed forms. All treatment consent forms must be signed and scanned into the patient management system on the day of treatment.
Post-operative follow-up call. Ideally three to seven days after surgery, a follow-up call checks on the child’s recovery. Use clinical judgment about whether an in-person follow-up is needed or whether a phone call suffices.
Quick Reference
| Phase | Time | Key Actions |
|---|---|---|
| Introduction | Ten minutes | Confirm guardian, acknowledge anxiety, set expectations |
| Fasting Education | Variable | Five-hour rule, teach-back method, document confirmation |
| GA Day Walkthrough | Variable | Induction, parent presence, reassessment, recovery timeline |
| Paperwork Completion | Remaining time | All required forms completed and signed in office |
Knowledge Check
Before continuing, consider these questions:
- Why must fasting instructions be explained with absolute clarity rather than softened language?
- What eight items are required for every GA patient regardless of facility?
- What additional forms does an ARH case require compared to an AFD case?
- Why must the GA facility fee be submitted on the same claim as the dental treatment?
- How would you handle a parent who expresses high anxiety about anesthesia?
Next Reading
Continue to: Insurance Pathways and Deadlines