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Center For Dental Medicine

Evaluation and treatment of head, face, and jaw pain

Please complete these forms

If you would like to visit us for an evaluation and diagnosis of your pain, please complete these three forms. The first is to give us permission to get information about your problem from other health care providers. The second is a comprehesive health questionnaire. The third gives us information that will rate the severity of your symptoms and help us to make an accurate diagnosis.

You may print the forms and fax them to us at 877-748-9620. You may also mail them to us at Santa Fe TMJ, 2019 Galisteo St, J2, Santa Fe, NM 87505.

The forms are most useful if we receive them a few working days before your appointment.

1. Permission for release of records

2. Health Questionnaire

3. TMJ Scale

Call us

If you are here to learn if your pain might be TMD, we are happy to answer by phone any questions you may have. Call us at 505-466-4728.

If you would like to make an appointment, we feel it is best to do so by phone. Computerized appointment systems try to make you fit the system. We try our best to fit your needs.