Anesthesia query Please fill out the short questionnaire below to find out whether anesthesia is a suitable option for you. First name Last name 1. Age2. Height(cm)HiddenÉletkori pont14HiddenÉletkori pont14-50HiddenÉletkori pont+503. Body weight (kg)4. What kind and how many types of heart medication do you take?HiddenBMIHiddenBMI<33HiddenBMI>335. Do you have a cardiologist? Yes, I do No, I do not Name 6. Do you have a pulmonologist? Yes, I do No, I do not Name 7. If you are injured or cut, how long does it usually bleed? 3 minutes 10 minutes 30 minutes 8. Have you ever been sedated? Yes, and I didn’t experience any complications Yes, and there was a complication No I have not 9. How many seconds can you hold your breath? Less than 30 seconds More than 30 seconds 10. If you have to walk up several flights of stairs, how many floors could you reach without stopping to take a break?HiddenOrvosi pontHiddenSéta pontszámHiddenSéta pontszámHiddenSéta pontszámHiddenÖsszes szerzett pontEmail(Required) Phone By filling out the test form, I accept the data management regulations of Hungarodental Kft., as well as consent to further inquiries related to the subject by email and phone, and I declare that I have already reached the age of 18. Accept PhoneThis field is for validation purposes and should be left unchanged.
