Patient Resources
Dental Sleep Apnea, Snoring & TMJ Treatment Center
Welcome to our treatment center. Welcome to better health.
190 GARDNER AVENUE, SUITE 5  BURLINGTON, WI 53105  PH 262.342.0191
FAX 262.763-7034  INFO@DSASTMJ.COM
Our patients tell us that it is often easier for them to complete their history forms in the comfort of their own homes, with their own records available for reference. In an effort to make your experience as totally comfortable for you as possible, we are pleased to provide the following forms for you to complete prior to your visit to the Dental Sleep Apnea, Snoring and TMJ Treatment Center.  Please click on the form for a PDF version that can be printed.

Snoring & Sleep Apnea Forms:

Billing and Insurance Policy
Chief Complaints
Contact Information
Epworth Sleepiness Scale
Health Questions
Last Week Questionnaire
Questionnaire for Sleep Apnea

TMJ Forms:

Billing and Insurance Policy
Contact Information
TMD Questionnaire

Click below for additional information:

American Academy of Sleep Medicine
American Academy of Dental Sleep Medicine
American Sleep Apnea Association
Up To Date
Apnea Support Forum
Please remember to bring your completed forms with you to your appointment or, if you prefer, send them at least one week in advance to the address below. Thank you!