|
Helping you and your patients handle oral medicine problems...
At The Center, we offer
patients hope for dry mouth, burning mouth and tongue, lichen planus, TMJ
and facial pain disorders, myofascial pain dysfunction, Sjogren's syndrome, candidiasis, cicatricial
pemphigoid, altered taste, leukoplakia, recurrent aphthous ulcers, psoriasiform
mucositis, macroglossia, sodium lauryl sulfate issues, geographic tongue,
dysguesia, and many others. |
|
To refer a patient ...
Use the link below to access our referral forms. You may print a form,
complete and either trifold and mail, or fax to us. We will then contact your patient to
schedule an appointment with our clinic.
Thank you for your referral!
|
|
We see patients on referral only. Please print and complete the referral form
(click link above) and fax or mail to us, and we will contact your
patient directly to
schedule an appointment. During this telephone call, we will discuss
many issues with your patient. We will explain that a packet will be
mailed to them (we can also fax or e-mail patient packets), which will
include medical history forms, directions and a map.
It is very important that the medical history forms be
completed prior to the appointment, to help us more
comprehensively treat your patient. Lastly, we
discuss forms of payment accepted, and ask that the patient bring
insurance information with them to their appointment, so we may file for
their reimbursement. Speaking with the patient directly avoids many
questions and unknowns the patient may have, and also helps us to find a
time that works well for our doctors and your patient.
|
|
Patients, download paperwork for your
appointment:
Dr. Parks - New
patient form
Dr. Parks -
IME patient forms
Dr. Zunt -
New patient forms
(if you are new or if it has been 18 months or more since your
last appointment)
Dr. Zunt - Medical
history update (if it has been less than 18 months since
your last appointment)
Please complete paperwork, including signing and dating any
authorizations, and bring to your appointment. If you have
questions before signing, please call Nikki prior to your
appointment. Thank you!
Click here for driving directions
(these are also included on patient forms, above).
Click here for a campus map. Click here
for campus maps
provided by IUPUI. |