919-682-5327 What to Bring:
- List of current medication, if applicable
- Dental insurance card, if applicable
- Previous X-rays and records or fax Authorization of Release of Information form from previous dental provider
- Please print and fill out the following forms:
*This form is to be sent to previous dental offices for records and X-rays. For this form, please add to the Please Forward/release my health information to:
Dr. Alex Fleming
1020 Broad St.
Durham, NC 27705
frontoffice@durhamncdentistry.com
- Authorization for Release of Information
- Consent for Treatment
- Consent for Use and Disclosure of Health Information
- Directions to Our Office
- Notice of Privacy Practices (read-only)
- TMJ/Facial Pain Questionnaire
- Acknowledgment of Receipt of Notice of Privacy Practices
What to Expect:
We will treat you with respect. You will meet with our dentist, Dr Alex Fleming, to evaluate your symptoms and review the TMJ form. With the help of a dental assistant, Dr. Fleming will document conditions and take measurements of your teeth relationship and opening of the mouth. We will listen for noises from your TMJ joint. Digital X-rays may be recommended. For more information about TMJ treatment in Durham, North Carolina, we welcome you to contact our dentist and dental team today by calling our office at 919-682-5327. We are eager to care for you.
