TMJ QuestionnairePlease fill out this brief questionnaire to help determine if you might be suffering from TMJ"*" indicates required fieldsName* First Last Email* PhoneDo you have difficulty, pain or both when opening your mouth (eg. When yawning) Yes No MaybeDoes your jaw get stuck, get locked, or go out? Yes No MaybeDo you have difficulty, pain or both when chewing, talking, or using your jaws? Yes No MaybeAre you aware of noises in the jaw joints? Yes No MaybeDo your jaws feel regularly stiff, tight, or tired? Yes No MaybeDo you have pain in or near your ears, temples, or cheeks? Yes No MaybeDo you have frequent headaches, neck aches, or tooth aches? Yes No MaybeHave you had a recent injury to your head, neck, or jaw? Yes No MaybeHave you been aware of any changes to your bite? Yes No MaybeHave you been previously treated for unexplained facial pain or a jaw joint problem? Yes No MaybeCommentsThis field is for validation purposes and should be left unchanged.