Patient Forms

Patient Forms

Please click below to access the appropriate form and proceed to download the correct PDF document needed.

  • For New Patients, please fill this form out and email to chukhmandds@gmail.com or print it out and bring it with you to your first appointment

  • For existing patients please fill out the health history update form if you have had any major medical changes including to medications or allergies since your last visit

  • For existing patients this form is often used before patient consults for TMJ therapy and other advanced care