PATIENT FORMS
Once you book an appointment, you will automatically receive new patient intake forms. Please complete these forms at least 24 hours prior to your appointment, so Dr. Maijer can prepare for your first meeting.
We are committed to coordinating care with your existing health care providers and are happy to request patient records on your behalf. You can also ask your doctors and other healthcare providers to send us a copy of your records.
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Please let us know if any of the following are available:
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FROM YOUR DENTIST OR ORTHODONTIST
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Dental or orthodontic x-rays, specifically
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Panorex x-ray
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Cephalometric x-ray
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Recent dental models or digital scans
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CBCT image
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FROM YOUR DOCTOR
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A home sleep study report
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A polysomnogram (PSG) sleeps study report
Please use the appropriate form below to inform us which providers have records that we may need. Signed forms can be brought to your appointment, emailed or faxed.
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HEALTH INFORMATION RELEASE FORMS
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