Self Assessment

Evaluate your level of function. Be sure to check off any present or past symptoms. Please be advised this is simply a self-assessment tool and is not a medical diagnosis. Contact us today to begin forming the collaborative team you may need!
 
  • __Mouth breathing

  • __Snoring

  • __Clenching/grinding

  • __TMD (jaw pain)

  • __Daytime sleepiness

  • __Insomnia

  • __Restless Sleep

  • __Sleep Walking

  • __Bed wetting beyond 6 yrs

  • __Frequent sore throat

  • __Strong Gag Reflex

  • __Difficulty swallowing certain foods

  • __Picky Eater

  • __Open Mouth Chewing

  • __Difficulty swallowing pills

  • __Chapped lips

  • __Crowding/malocclusion

  • __Frequent congestion

  • __Asthma

  • __ADD/ADHD

  • __Acid reflux

  • __Anxiety/chronic stress

  • __Family hx of OSA

  • __Chronic head/neck/shoulder pain

  • __Chronic ear infections

  • __Chronic migraines/headaches

  • __Speech issues

  • __Tongue rests low/protrudes

  • __Thumbsucking

  • __Nail biting

  • __Prolonged Pacifier

  • __Receded chin

 

Wondering what your results mean!? Schedule a consultation today.