Forms
To help us serve you better and protect your valuable time, please download these forms, complete them to the best of your ability, and e-mail them to us or bring them to your first appointment. If you do not have complaints about your TMJs (jaw joints), disregard that form.
These forms give us a better, more complete understanding of how to treat you when you come visit us. If you have any questions whatsoever regarding the forms, please give us a call at (573) 449-2311. You can also visit our contact page to fill out your information, and we will then respond to you as quickly as possible.
We encourage any patients who choose to return these forms in person fill them out before coming to our office for an appointment. This will allow us to process the information therein quickly, and allow us to begin your visit promptly. Our hope is that, in total, these forms will not take you more than 15-20 minutes.
Please email completed forms to office@drfootedental.com or mellony@drfootedental.com.
Confidential Info Questionnaire-Insurance Info
Temporomandibular Disorder Questionnaire
Please use Adobe Acrobat Reader to fill out and save information filled out on the above forms. Web browsers such as Internet Explorer, Chrome and Firefox may not support fillable PDFs.
Download Adobe Acrobat here.