IS MYOFUNCTIONAL THERAPY RIGHT FOR YOU?
Answer these questions to help determine if myofunctional therapy may be a good fit for you or your child.
WHO IS THIS CONSULTATION FOR?
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Myself
My Child
Adult Screening Section
Please complete the following questions if the consultation is for yourself.
What made you start looking into myofunctional therapy?
What symptoms, concerns, or recent experiences led you here?
Do any of these sound familiar?
I snore
I breathe through my mouth during the day
I wake feeling tired or unrefreshed
I grind or clench my teeth
I wake with a dry mouth
Clicking, or tightness
Neck or shoulder tension
Frequent headaches
Facial asymmetry
Forward head posture
Difficulty keeping my lips closed at rest
My tongue rests low in my mouth
I chew mostly on one side
I bite my cheeks or tongue
Have you ever been told…
I may have a tongue or lip tie
I may need orthodontic expansion
I have airway concerns
I may have sleep apnea
None of the above
What are you hoping to improve?
Myofunctional therapy is a structured process focused on long-term functional change. During your consultation, we’ll discuss whether this approach feels like the right fit for you.
Yes
No
Maybe
Full Name
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Child Screening Section
Please complete the following questions if the consultation is for your child.
What concerns led you to explore myofunctional therapy for your child?
Do any of these sound familiar?
Snoring
Mouth breathing
Restless sleep
Grinding teeth
Waking tired
Dark circles under the eyes
Thumb sucking
Nail biting or chewing objects
Difficulty keeping lips closed
Open mouth posture
History of tongue or lip tie
Picky eating
Texture sensitivities
Speech articulation concerns
Forward head posture
Neck or shoulder tension
Facial asymmetry
Has your child ever…
Had orthodontic treatment
Been told expansion may be needed
Seen an ENT for airway concerns
Had a sleep study
Had a tongue or lip release
None of the above
What would you love to see improve for your child?
Parent Name
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Child's Name
*
Child's Age
*
Based on what you shared
The concerns you selected are commonly associated with patterns we evaluate in myofunctional therapy. When multiple concerns are present, it can sometimes indicate a stronger pattern that may benefit from support. While this doesn’t confirm that therapy is needed, it does suggest that a consultation could be helpful in determining whether this is the right fit.
Next step: schedule your consultation to explore this further
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