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ST KYROLLOS FAMILY CLINIC DR. ASHRAF SADDIK PN. 65028KB 2 A Moore Street, Coburg VIC 3058 Tel (03) 9386 0900 Fax (03) 9386 5388 ASHRAF SADDIK PTY. LTD. ABN 20 060 815 401 CONSENT& OPERATIVE CARE SHEET
 Please read carefully the enclosed information sheet about circumcision, if you still have any concerns or need to ask more questions please don’t hesitate to address them.  Dr. Saddik will tell you how much paracetamol should be given to your Son, after the operation if your child needs it. This dose depends on his weight, age and size according to Royal Children’s Guidelines. Please bring with you - (1) Panadol (2) Clean disposable nappy (3) a clean blanket for your child.  On arrival Dr. Saddik will examine your child to ensure there is no reason not to perform the operation. He might give your child pre-operative a dose of Phenergan as a mild
sedative. Also local anaesthetic would be given at this pre-operative stage. This local
anaesthetic will take up to one hour to take affect. Dr Saddik will apply the Emla local
anaethetics cream one hour before the operation. That would be followed by local
anaethetics injection just ten min. before operation. Older kids may require sedations.
 During the procedure you will be asked to wait outside. St. Kyrollos Family Clinics trained staff would assist Dr. Saddik, NO relative / parents’ attendance is permitted.
 Your child will be observed and monitored post-operatively to ensure child is fed, void, no bleeding, good pain control, no reactions to anaethetics and an opportunity for parents to ask any further questions. You would be nursed in a separate room for your child’s comfort. Your child would have his meal, either Breast / bottle-fed post-operatively to ensure no vomiting.  St. Kyrollos Family Clinic ensure that on leaving, both the child and parents are happy and that the child is pain free, nursed, fed and with no complications with full recovery  On leaving, we would ask you to fill up simple questionnaire about the service. We encourage you to fill up with your comments that will help us to improve our service.  There would be a gauze bandage around the cut. You will not need to change the gauze, but every time you nurse your child soak it with olive oil. Reasons for Olive oil: (1) smells nice, (2) soften up the wound and (3) helps the healing process. You will need to leave the bandage gauze around the cut as it is for three days. On the third day (unless fallen before) you will bath your child in warm salt water and the gauze will fall off by itself. Please ensure enough lengthy time socking in warm salt bath esp. with older kids.  You will receive a courtesy call the next day, and we encourage you to make a follow-up  Dr. Saddik will see your son within a week and he will be more than happy to be contacted on his mobile number (0411121230) in case of emergency at all times or contact the surgery during normal hours on 9386 0900.  Dr. Saddik will advise you at the initial consultation of any “out of pocket” expense there  If you have any concerns in the post recovery-healing period or any complications arise, please return to the clinic, call up Dr Saddik, or organize a follow up appointment. Our work is guaranteed and we will be more than happy to address any issues. I / We _____________________________________________________

Signature _________________________________________ Date___________

Source: http://www.circumcisiondoctor.com.au/index_htm_files/SKFC-CIRCUMCISION%20CONSENT%20FORM-.pdf

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Congratulations on your pregnancy

CONGRATULATIONS ON YOUR PREGNANCY Thank you for choosing and trusting in the doctors of OB/GYN Health Partners to care for you throughout your pregnancy and your delivery. Please be assured that our goal is a healthy and safe delivery for both mother and baby. We please ask you not to hinder our medical decision process by asking us to review or read a birth plan. OB/GYN Health Partners d

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