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1.281.494.3368
1730 Williams Trace Blvd Suite E Sugar Land, TX 77478
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Meet Dr. Imrek, DDS
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TMJ Health Questions
Do you get headaches in the temples?
(Required)
Yes
No
Do you frequently have neck pain?
(Required)
Yes
No
Are your jaw muscles tired when you awake?
(Required)
Yes
No
When is pain worse?
(Required)
Yes
No
Have you ever had severe blow to the head/jaw?
(Required)
Yes
No
Is there family history of TMJ?
(Required)
Yes
No
Do you hear ringing, buzzing or hissing in ears?
(Required)
Yes
No
Has your jaw ever locked (unable to open or close)?
(Required)
Yes
No
Have you ever had a sleep study at a Sleep Clinic?
(Required)
Yes
No
General Questions
How do you feel about the condition and appearance of your smile?
What would you like to improve about your smile?
Do you want to save your stem cells?
Do you have any additional concerns or comments?
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