TestForm PEDIATRIC DENTAL OFFICE FLOOR PLANNING Client NameClient Billing AddressName and contact Info of leasing agent or propertyBuilding/Space Site AddressTell us about this office locationSatellite OfficeMain officeGround Up building shellLeased space in a medical/dental plazaLeased space in a professional plazaLease space in mixed use retail/business centerStand alone bank building converting to pedo/ dental OfficeStand alone restaurant convert to pedo/dental OfficeStand alone professional/medical buildingIs this a multi story buildingIf multi story, which floor is your office locatedDo you own the building?RECEPTION ROOMIs there shopping close by where parents can go while the patient is in treatment?Is this office is located in a rural or semi-rural area where parents tend to bring in the whole family?Do you want a separate children’s play area in the reception room?Would you like a refreshments counter in the Reception Room?Would you like a place to hang coats?FRONT DESK/PATIENT CHECK OUT# of staff at front desk on a permanent basis?Equipment: Do you need any equipment (other than computers) at the front desk? If yes please list equipment below.Could be printers, photo copier Ipad w/auto patient check in.Do you want semi private patient check out?Or do you want a fully private patient check out where pediatric patients are not seen from the reception area?Do you want a separate exit/check-out for surgical patients so they do not traffic back through the reception area?BUSINESS OFFICEHow many work stations do you want in the business office?What will be the function of the work area, insurance, business, patient call backs?Do you want seating in the business office so that parents can sit down to discuss account status?I do not want a separate business officeEQUIPMENT DESKDo you need a central equipment desk for business machines: credit card processing, copier, postage, printer?Or will all business transactions be digital?Or equipment will be located at workspace rather than a central location?IMAGING ROOMWhat type of X-ray equipment will you be using: PanCeph, ICAT or other?Pan-CephSeparate Alcove with PA Head and chairIMAGING AT TREAMENT AREASWill you need PA heads at private ops?Will you need PA heads at surgical rooms?Will you need PA heads at Hygiene?Will you use portable X-ray units?HYGIENE BAYHow many hygiene patient chairs do you want?Do you want a full partition wall between each hygiene chair?Or do you want a partial partition wall between each chair?Or do you want a fully open hygiene bay?Do you want an alcove play area for toddlers in the hygiene area?Will you perform a lap exam in the hygiene bay?Or do you want a separate bench/alcove area where you can perform a lap exam?If exam is performed at hygiene bay, will the patient be in the exam chair?Or do you want a parent chair at the foot of the exam chair where you will complete the exam?Will you be using a side cart at hygiene?Will the side cart be positioned at 9 o’clock, to the right side of the patients?Or will the side cart be positioned at the 1 o’clock position, on the left side of patients head?Task Lighting at Hygiene:Monopoint ceiling mount exam lights at each hygiene chairTrack mounted exam light system?Chair Mount exam light?Or dental loupes exam lights?QUIET OPS/SURGICALWill you provide conscious sedation only?Or will you also provide unconscious sedation?Doe you prefer rear delivery?Or side delivery?SCANNERSWill you be using scanners at Hygiene Bay?Will you be using a portable hand held device for scanning?Or a portable Itero type floor unit on casters?Exam LightsMonopoint ceiling mount exam lights at each hygiene chairTrack mounted exam light system?Chair Mount exam light?Or dental loupes exam lights?Will you be using a scanner at quite ops/surgical?If yes, will this be a handheld device?Or a Itero type scanner on casters?TV MonitorDo you want a TV monitor above the patient head?Do you want a TV monitor mounted on the wall at the foot of the treatment chair?I do not want any TV monitors?STERILZATIONHow Many sterilizers do you want to plan for?Do you want sterilizers to be stacked one above the other?STERILZATION continuedOr side by side?Will you be using steam sterilizers/Autoclave?Or Dry heat sterilizers?Will you use ultrasonic?Ultrasonic: How many gallons?Or hydrim washer?If ultrasonic will you use above counter?Or do you want it countersunk?Would you like a compressed air nozzle above the counter?Do you need a water purification system installed under sterilization sink to refill water bottles at treatment chair side unit?Or will you be purchasing bottled water?Do you need undercounter refrigerator for bonding agents in the clean tray area?Or in an undercounter refrigerator in the Hygiene Bay Area?LAB/3D PRINTINGDo you need a lab work counter?If yes, how long do you want the counter to be? 4’,Do you need compressed air at lab?Will you be using 3D printers?If yes, how many printers will you use?Will you need a small sink in this area?DOCTOR’S OFFICEHow many doctor’s work stations do you need?Or in a more private area?I do not want a doctor’s officeHow many doctors work stations will you need?Do you want seating for private conversations with staff?WASHROOMSAre public washrooms available?Do you want a private doctor’s washroom?Do you want a private doctor’s shower?Do you want a staff washroom?If yes, do you want the staff washroom located close to the treatment area for patient use?STAFF LOUNGEWill you be using the staff lounge for lunch and educational presentations?How many chairs to you want?Do you want staff lockers?Do you want a dishwasher?Do you want an insta hot water dispenser?Will the refrigerator be an apartment size single door?Or full size double door?With ice dispenser?Water dispenser with filter?Do you want a garbage disposal?STORAGEWould you like Bulk storage/UPS drop off close to the staff entrance?Would you like clinical storage close to Treatment Areas?Server EquipmentWill you need a separate server closet?Or will a server cabinet with ventilation slots be adequate?MED GASESPlease list med gases below Δ