Here are all the forms you will need before your appointment. You can print these and fill them out before your visit. Thank you!

 

[one_half] patient-forms-dr-gerardoAll Patient Forms in One Packet

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confirm-to-consentConfirm to Consent

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patient-payment-agreementPatient Payment Agreement

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confirm-to-consentArbitration Agreement

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direct-paymentDirect Payment Form

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TMD DisabilityTMD Disability Index

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TMD Symptom IntensityTMD Symptom Intensity Scale

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patient-case-historyAny Body Pain VAS

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patient-case-history-p1Headache Pain

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patient-case-history-p2Neck_Pain

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patient-case-history-p3Patient Case History page 3

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Any Body Pain VASAny Body Pain_VAS

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Headache PainHeadache_Pain

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Neck PainNeck_Pain

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