Please Fill Out Our Patient Intake Form
Do you experience pain while eating or chewing?
Do you clench or grind your teeth, especially at night?
Do you experience difficulty in opening or closing your mouth?
Do you have difficulty speaking or swallowing?
Do you experience headaches along with your jaw pain?
Do you have neck pain or stiffness?
Do you experience ear pain or ringing in your ears (tinnitus)?
Do you have any facial muscle tenderness or fatigue?
Do you have a high-stress lifestyle or experience frequent stress?
Thank you for taking the time to complete this questionnaire. Your responses will help us create a personalized treatment plan to address your jaw pain and improve your overall function and well-being
