Patient Update Sheet

Angina

Arthritis/ Rheumatism

Artificial Heartvalves

Asthma

Abnormal Bleeding with Extractions or Surgery

Cancer

Chemotherapy / Radiation

Diabetes

Epilepsy / Seisures

Hearing Loss

Heart Condition/ Surgery

Hepatitis/ Type

High Blood Pressure

HIV Positive

Jaundice / Liver Disease

Nervousness / Anxiety

Pacemaker/ Defibrillator

Shortness of Breath

Sinus Problems

Stroke

Swelling Feet/ Ankles

Taking Aspirin, Coumadin or Blood Thinner

Thyroid Problems

Tuberculosis

Tumor I Growth on Head or Neck

(Women) Are you currently pregnant?

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