Dear friend,
Please select the appropriate initial visit form for yourself or your child.
If you or your child have a problem with TMJ (jaw joints) or symptoms such as grinding/clenching of teeth, facial muscle pain, frequent headaches - please fill out TMJ questionnaire as well. Feel free to send it to us via fax or bring the forms with you for your initial appointment.
New Child Information Form Fill Out & Submit Online
New Adult Information Form Fill Out & Submit Online
TMJ Questionnaire Fill Out & Submit Online
CT Scan Fill Out & Submit Online
*These forms require Adobe Acrobat Reader to view. If you do not have Adobe Reader already installed on your computer, click the Adobe logo above to download.
**We are committed to keeping your personal information secure. All of our online forms are submitted via a secure connection and are HIPAA compliant.
***For Apple/Mac Users: You must use Adobe Acrobat Reader to submit the forms. To do so, simply right click on the form and save form. Open form in Acrobat Reader, fill out the form and submit.