If this is your first time visiting a physician at TMJ Pain Treatment Centers, you will be asked to give us information about your:
- General Health
- Previous diagnosis and treatments (including EMG, MRI, CT scans)
- Health insurance
If you have medical records related to your visit with us, please send them in writing (fax or mail) before your visit. This allows our doctor to be fully prepared before your visit, so your appointment can run smoothly.
This is a list of signs and symptoms commonly associated with Temporomandibular Joint Disorder (TMJD) and/or Myofascial Pain Dysfunction (MPD).
Please complete this checklist as it will help identify if you have any evidence of TMJ or MPD. You can print a copy and bring it with you at your first appointment
Take our interactive
TMJ questionnaire
Please take the time to complete the New Patient form prior to your first visit and provide as much information as possible so that our doctors can provide you with the best care.
Patients have the option of completing the forms below on the computer and printing them out or printing them out and completing them by hand (black ink please).
New Patient Forms
Other items to bring to your appointment:
- Insurance card(s)
- Driver’s license
- List of names, addresses and phone numbers of other current medical providers
- If family/friend referred you, bring name and address of your family member or friend
An orofacial pain dentist will evaluate and review your current symptoms and medical history, examine area of the face, teeth, jaw, head and neck, and order any diagnostic testing if necessary. Typically this will include radiographs, imaging studies, and questionnaires. Also, the dentist will provide a self-care program to reduce any strain to the area and encourage healing. A treatment plan will be developed and if necessary sent to your insurer for prior authorization and a summary letter will go out to your referring doctor.