Myofunctional Therapy Doctor Forms

Below are resources that dentists and other medical professionals can use to easily refer patients. Our forms can be filled online, saved to your computer and emailed to our office. Should you have any questions or need assistance please do not hesitate to contact Pat.

Printable Forms
Referral Source Form
Doctor introduction letter
Referral Source Myo Measurements
SPOTS screening tool

Fax: (402)513-7877

Patient Referral

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