All TMJ patients that would like to have a consultation should fill out the following forms before the appointment is made.

The appointment will be for one hour and the forms must be filled out and returned to the office before the appointment so the Dr. Luffey has time to review them before you arrive. This enables Dr. Luffey to have more time to ask more specific questions during the consult. Make sure to tell the receptionist which office you would like to visit. Appointments will not be made, whether they are in the Santa Fe office or in the Albuquerque office, until all of the forms are returned and a fee of $ 200.00 has been paid.

The following forms are used to assist in the diagnosis of the myriad of symptoms that can arise from things such as sleep apnea, TMJ, chronic fatigue syndrome, breathing disorders, anxiety and many others.

(Click the form below to view and print)

  1. Breathing Questionnaire
  2. Breathing Checklist
  3. Head and Neck Pain Questionnaire
  4. Sleep Apnea Questionnaire