Sleep Well Anesthesia Services Informed Consent Information
The practice of medicine is not an exact science. The reactions of each person can vary. Even when performed correctly, a procedure can be associated with an extreme risk of serious bodily injury or death.
The following is a brief description of the pain mitigation treatment which will be available to you.
Please read carefully and discuss this in detail with your provider.
Electrodes should only be applied to areas with NO PAIN
Patients are asked to identify a clear and specifc perimiter of pain; the pain zone or zones. The electrodes will be then placed above /below or side/side of established pain zones.
There should not be any discomfort
Notify the technician if you are feeling any discomfort from the placement of the electrodes so that they can be repositioned or removed altogether.
There WILL be potentially unfamiliar, but not painful sensations
Initial sensation may present as a slight bee sting or slight prickling that should turn into a slower, deeper vibratory sensation, reported as a hum, buzz or vibration once treatment has begun.
You may be tired after treatment
Patients often report feeling tired or sleepy during and/or after the therapy.
Patient Statement
Prior to your procedure, your Treatment Plan will be discussed with you. Please read this entire form and acknowledge that you understand the following:
- That this information is provided so that you can make an informed choice about proceeding with elective pain management treatment.
- That you understand and give consent to the treatment planned, reviewed, and explained by your provider, and further understand that outcomes vary and there is no certainty that this treatment will decrease or alleviate your pain.
- That you have read this information and understand that you have the opportunity to ask questions and discuss the treatment plan with the Nurse responsible for your care.