Dental Pain Telemedicine Visit
  •  - -

  •
  • Format: (000) 000-0000.
  • What was your gender at birth?*

  • You should NOT use Omnia TeleHEALTH if you are experiencing an emergency. Emergencies include but are not limited to:

    • Severe or unusual chest pain
    • Severe shortness of breath
    • Symptoms of a stroke (such as facial drooping, arm weakness, or speech difficulties)
    • Thoughts of harming yourself or others
  • ARE YOU EXPERIENCING AN EMERGENCY? IF YOU ARE EXPERIENCING AN EMERGENCY, CALL 911 OR GO TO AN EMERGENCY ROOM IMMEDIATELY.*
  • Are any of your teeth knocked out of their normal position?*
  • When did your dental pain start?*
  • Which tooth hurts? (Select ALL that apply)*
  • Please rate the severity of your dental pain on a pain scale, with 0 being no pain and 10 being the worst pain you can imagine.
  • In addition to dental pain, do you have any of the following symptoms? (Select ALL that apply)*
  • In addition to dental pain, do you have any of the following symptoms? (Select ALL that apply)*
  • In addition to dental pain, do you have any of the following symptoms? (Select ALL that apply)*
  • Do you currently have difficulty breathing?*
  • Do you feel feverish?*
  • Do you have chills?*
  • Image field 68
  • Please feel your neck. Are the lymph nodes in the neck enlarged?*
  • Did your tooth pain begin after any of the following? (Select ALL that apply)*
  • Is there any significant facial injury such as injury to the eyes, nose, jaw, or bones of the skull?*
  • Is the tooth pain a result of a dental procedure that was performed within the last week?*


  • Most people with dental pain take nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen and naproxen for relief of pain, but those with chronic kidney disease should not take NSAIDs.

  • Have you been told by a provider to avoid NSAIDs?*

  •  

    Depending on your symptoms, an antibiotic may be prescribed which can sometimes cause yeast infections.

     

  • Do you typically get a yeast infection when you take antibiotics?*
  • What has successfully treated your yeast infections in the past? (Select ALL that apply)*
  • Do you typically need 1 or 2 doses of fluconazole (Diflucan) to resolve the yeast infections?*
  • Are you able to upload a picture of the tooth or area causing pain? (A picture may be required to complete the visit)*
  • Browse Files
    Drag and drop files here
    Choose a file
    Cancelof
  • Do you have any medication allergies?*
  • Are you currently taking any medications?*
  • Are you pregnant?*
  • Are you breastfeeding?*

  • PHARMACY INFORMATION

    Please choose where you would like your prescription sent
  • Would you like to add any additional information or questions for the provider to see?*
  • prevnext( X )
    Telemedicine Visit Product Image
    Telemedicine Visit
    $39.00
      
    coupon loading
    Total
    $0.00
  • Should be Empty: