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Adult Online Assessment

Complete the quiz below to help determine whether orofacial myofunctional therapy could be beneficial for you.

Snoring

Do you snore or has anyone ever told you that you snore?

Sleep Appliances

Do you wear a night guard or sleep appliance at night?

Sleep Apnea

Have you been diagnosed with sleep apnea or any other form of sleep disordered breathing? Have you been diagnosed with sleep apnea or any other form of sleep disordered breathing?

Tongue Ties

Did you have a tongue-tie surgery as an infant, or has a healthcare provider ever told you that you are tongue-tied?

Prolonged Thumb or Pacifier Sucking

Did you suck your thumb or fingers as a child?

Headaches or Teeth Grinding

Do you have frequent headaches, or do you clench or grind your teeth? Do you have frequent headaches, or do you clench or grind your teeth?

Mouth Breathing

Do you notice that you breathe through the mouth at times, either during the day or night?

Tonsils & Adenoids

Do you have large tonsils and adenoids, or have they been removed?

Allergies or Asthma

Do you have allergies or have you been diagnosed with asthma either as a child or an adult?

Orthodontic Treatment

Have you had orthodontic expansion or do you have a narrow palate?
Opt-In to Electronic Communication

Please note that e-mail is not a secure form of communication. Medical information placed here may not be confidential. This form should not be used by children under the age of 18. If you prefer to speak to us directly, you are also welcome to call us so that we may assist you.

If you answered yes to any of these questions, we are here to help...

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MarvelMyo & Speech

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469-865-8057

FAX OUR OFFICE

817-668-0288

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MarvelMyo & Speech

Call Our Office

469-865-8057

Fax Our Office

817-668-0288
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HOURS
Monday
Closed
Tuesday
7:30am - 6:30pm
Wednesday
7:30am - 6:30pm
Thursday
7:30am - 6:30pm
Friday
7:30am - 6:30pm
Saturday
Closed
Sunday
Closed
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2025
BY
DENTALFONE

We are ready to help you or your child on your journey to optimal health!

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