If you are a new patient, please download and print the following forms prior to your initial diagnostic examination visit at MHRPA. Thank You!
Head Health History Form
This questionnaire is used to capture critical information vital about your head health history, dental work you’ve had that relates to your dental forces, pain symptoms and locations, traumatic accidents, lifestyle and habits.
Headache History Form
This questionnaire is used to collect information about your health and headache history, including any previous diagnoses and testing, medications you’ve taken, pain locations, severity and intensity.
New Patient Registration Forms
Please click here to be directed to a secure portal in order to fill out 5 webforms prior to your visit. These forms are in addition to the two previous PDF’s. Thank you and we look forward to seeing you!