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Patient Forms

New patients, prior to making your first visit, need to fill out the appropriate forms. Please select the forms you need below, then fill out and print and bring with you to the office.


Adult Medical History

This form should be completed by all patients 18 years or older. Please try to fill the form out as completely as possible.

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Child Medical History

This form should be completed by the parent or guardian of any patient under the age of 18. Please try to fill the form out as completely as possible.

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TMJ/TMD Questionnaire

This form is for patients that have been diagnosed with TMD, TMJ or MSD or are scheduling an exam for the first time after experiencing symptoms.

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Additional Needs Patients

Patients that may require special care should complete this form. Please indicate any physical and/or mental conditions that may affect treatment.

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