Interested In Joining Our Team?

Fill out the form below and our team will be in touch to let you know the next steps.

TMJSTC Inquiry Form

Date*
MM slash DD slash YYYY
Name*
First Last
Phone*
Email*
Number of years as a dentist:*
Current practice location:*
Certifications:*
Please select all that apply:*
- Solo Practitioner
- Partner
- Associates
If yes to Partner or Associates, please indicate how many:
How many hygienists work in your practice?*
How many days per week to each work? (Hygienist 1)*
How many days per week to each work? (Hygienist 2)
How many days per week to each work? (Hygienist 3)
How many days per week to each work? (Hygienist 4)
How many days per week to each work? (Hygienist 5)
How many patients do they see per day?*
How many days do you practice per week?*
Why are you interested in becoming a TMJ & Sleep Therapy Centre?*
How many other dentists in your region market themselves for TMJ/Sleep Tx:?*
Describe your experience in treating Craniofacial Pain / TMD and Sleep:*
What are your short term goals? (1-3 years)*
What are your long term goals? (5+ years)*
Desired TMJ Centre Region:*
Number of hours CE in Craniofacial/Orofacial Pain and Sleep:*
Year 1: Annual income expectations:*
Years 2-3: Annual income expectations:*
Years 5+: Annual income expectations:*
What is your current marketing budget?*
Equipment available:*