Myobrace private eye home sheet

Dr. Christa Engelbrecht Dental

 

Myobrace Private-Eye Home Questionnaire

There are many things about your child's health that are important to know, but that I often don't get to see at the practice. Also, there are signs to look for that you may not have known were connected to your child's teeth or health. By looking for and tracking these 'signs and symptoms, we can get a better handle on the problem and watch for resolution. You don't have to spend a lot of time with this. Just watch for certain things at different times of the day. Try not to let your child know they are being watched. You want to see the most natural behaviors. Check off what you see in the list below. If you are not sure, check it anyway. Please make comments if you want.

Name
MM slash DD slash YYYY
During a meal, does your child;
While sitting around (watch TV or in the car), does your child;
While talking, does your child;
While sleeping, does your child;
When your child wakes up in the morning, does your child;