The Smile Professionals : Dr. Claire Stagg DDS MS FAACP

Forms

Please complete these forms only if you have been asked to by our office. We will guide you as to the appropriate ones needed for your care that will be specific to your needs.

Disclaimer: Submitting preliminary healthcare or insurance information or making an appointment with the practice does not establish a physician-patient relationship. That relationship is not created until the practice has completed a preliminary in-office evaluation and then notifies the individual in writing that he or she has been accepted as a patient.

TMJ Scale

This test is used as an assessment tool for Dr. Stagg. It assists in evaluating and treating chronic pain and Temporomandibular Joint Disorders [TMD] and patient self-testing with the TMJ Scale. Please print out and bring the completed form at your next visit.

Headache Impact test (HIT)

HIT is a tool used to measure the impact headaches have on your ability to function on the job, at school, at home and in social situations.

Nutrition Symptom Survey Form

We use this survey as an evaluation to assist in your nutritional counseling. Established patients, please feel free to bring in the completed form to see which supplements we could recommend for your needs.

"I chose Dr. Stagg's office to address my dental needs. First, I was greeted by a friendly and knowledgeable staff that addressed my concerns promptly and to the point. I mean ALL my concerns from my appointments, insurance, and procedures. Second, the office environment was impeccable with a tranquil touch. I immediately found peace with myself, instead of the usual restlessness at previous dental practices. Talk about clean. The place was spotless. Even the restroom had hand towels as found at a five-star resort. Nice touch! Dr. Stagg has her act together, she has thoroughly thought through each process in her practice: the front desk requirements, environmentally appealing, trained staff, technology, patient comfort, patient education, and procedural care. A "total dental system" all for the care of the patient. What an experience! Did I mention I fell asleep while Dr. Stagg was replacing my fillings?"
~ John I: General Dentistry patient

2120 Highway A1A Indian Harbour Beach, FL 32937
View Map || Phone: 321.777.2797