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TMJ/ HEAD &
FACIAL PAIN
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ABOUT
Meet Our Providers
Technology
Hear From Our Patients
LOCATIONS
TMJ/ HEAD &
FACIAL PAIN
SLEEP DISORDERS
TONGUE TIES
HOLISTIC SOLUTIONS
Regenerative Medicine
CONTACT
Contact Us
Careers
Referring Patients
Home
ABOUT
Meet Our Providers
Technology
Hear From Our Patients
LOCATIONS
TMJ/Head & Facial Pain
Tongue Ties
Sleep Disorders
Holistic Solutions
Regenerative Medicine
CONTACT
Contact Us
Careers
Referring Patients
Menu
Home
ABOUT
Meet Our Providers
Technology
Hear From Our Patients
LOCATIONS
TMJ/Head & Facial Pain
Tongue Ties
Sleep Disorders
Holistic Solutions
Regenerative Medicine
CONTACT
Contact Us
Careers
Referring Patients
Patient Portal
Book Appointment
TMJ/Head & Facial Pain Quiz
"
*
" indicates required fields
Do you take over the counter or prescription medication more than 2 times a week for head or face pain?
*
Yes
No
Do you wake with headaches in the morning?
*
Yes
No
Does your jaw or face often feel sore or tired?
*
Yes
No
Does stress aggravate or create head or face pain?
*
Yes
No
Does your pain limit your ability to do daily activities?
*
Yes
No
PLEASE COMPLETE THE SMALL FORM BELOW AND WE WILL EMAIL YOU A COPY OF YOUR RESULTS IMMEDIATELY!
Note: Messages sent using this form are not considered private. Please contact our office by telephone if sending highly confidential or private information.
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