Patient Referral Refer a Patient for Expert Care Printable PDF What Are You Contacting Us About Today? Exam2nd OpinionSent ReportCall me Reasons for Referral (select all that apply): TMJ/TMD EvaluationTMJ/TMD Therapy with Day Orthotic & Night Sleep ApplianceClicking or Grating Sounds in the Jaw Joint (TMJ Noises/Slipped Disc Analysis)Jaw Locking (open or closed)Limited Mouth OpeningFacial Pain or Jaw PainPrimary Headache or MigraineNightlase for Snoring or Improving the AirwayDisturbed, Restless SleepDental Sleep Appliance for Sleep ApneaClenching/Grinding/Teeth Wear3D CBCT Scan (TMJ/Airway/Sinuses Analysis)Airway Concerns or EvaluationHealing Laser Therapy/Biostimulation for Muscle/Nerve PainReversal of Permanent Numbness with Prolozone and/or Laser TherapyClear Aligner (Orthodontic) Expansion Technique Patient Information Doctor Information Submit Δ
