Name: TMJ & Sleep Therapy Centre of Fort Wayne
Address: 9121 Illinois Rd., Fort Wayne, IN, 46804, US
Telephone: +1-260-434-0099

Has your sleep partner complained that you grind or gnash your teeth in your sleep?*
- Yes
- No
Do you experience chronic or severe facial pain concentrated near your jawbone, around your mouth, and/or below your ears?*
- Yes
- No
Do you suffer from migraines?*
- Yes
- No
Are you prone to headaches, neck pain, and shoulder pain?*
- Yes
- No
Does your jawbone area hurt when you eat, drink, or move your mouth?*
- Yes
- No
Have you ever experienced unexplainable ringing in the ears?*
- Yes
- No
Do you wake up in the morning and experience facial pain, soreness of the tissues around the jawbone, or headaches?*
- Yes
- No
Does your jaw make popping or clicking noises when your mouth moves?*
- Yes
- No
Please fill out the short form below and we will email you the results.
Name*
First Last
Your Email*
Phone*

Please fill out the short form below and we will email you the results.

TMD/HEAD & FACIAL PAIN