Instructions for Enhanced Forms


We know that your time is valuable. To ensure that your visit is as productive as possible, we recommend that you do the following:

  • Fill out all of the forms completely. Though some of the health history questionnaires may seem redundant, the information is essential for our providing you with the best care possible. We especially want to know about your previous caregivers and what specific complaints have brought you to our office.
  • Bring notes regarding your symptoms and concerns. Describe them briefly but thoroughly. Estimate
    how long you have had them. Grade each on a scale of 1 to 10, 1 being mild and 10 being severe.
  • When here, share what else is going on in your life (e.g., divorce, death of loved one, job change)
    and how you feel about it. This will allow us to get the most complete sense of your current health situation, how it is affecting you—and what is being affected by it.

In preparation for your visit, you also may find it useful to spend some time writing about the events in your life as they relate to your health or creating a timeline of your health issues and major life events. This can help you crystallize your sense of what’s going on with respect to your health (thus making it easier to recall and discuss during your visit) and perhaps even see relationships and patterns among the events that weren’t apparent to you before. If you do this writing, please bring it with you or include it with any paperwork or records you will be sending us in advance.

Other things you can do:

At your visit

  • Listen carefully and take notes.
  • Ask questions until you understand what you need to know.
  • Ask about all available treatment options, what Dr. Verigin recommends and why.

After your visit

  • Learn as much as necessary about your current health condition, consulting other sources of information as needed.
  • Consider the possible consequences of the proposed treatment options.
  • Get a second or third opinion, if appropriate.
  • Choose the treatment you believe will work best for you.
  • Decide on the best source to provide this treatment.

Knowledge Is Not Only Power – It’s Empowering!

The more you understand how your body works – and how it responds to illness and injury – the more you are able to do what it takes to ensure your wellness.

This is why we spend so much time talking with you about your dental health situation, how to treat it and why. It’s why we give you resources for learning more about your health and how to improve it. After all, the meaning of the word “doctor” comes from the Latin docere, “to teach.” So we not only provide you with dental care; we teach you how to take good care of yourself.

For this to happen, though, we can’t just be talking to you and handing you books and articles or referring you to websites. The root of the word “communication” means not just to impart but to participate. Communication is a two-way street. It’s not monologue but dialogue. And it’s a key component of Dental Health Fitness.

So we also listen to your needs, interests and concerns. This lets us give you information and care that’s specific to you, a unique and whole human being – not just some nameless, faceless mouth with teeth. Here’s how you can help us do this and get the most out of your visits.

Take Stock

Before your appointment, make time to reflect on your dental and general health. Write down any changes or problems you’ve been having. Note any questions you have for us. Make a list of all supplements and medications you regularly take or have been taking, both homeopathic and allopathic, prescribed and over-the-counter. You may find it easier to keep an ongoing list, adding to and deleting from it whenever you change your regimen. Make your list in a notebook you can keep with your supplements and medications. Then just bring it with you to your appointment.

Be Specific

Sometimes it can be hard to talk about our health. We may be embarrassed or just not used to having to really describe it. Or we may think that certain things aren’t relevant. But the more you can tell us, the easier it is for us to home in on any problems or potential problems. If you have trouble finding the right words, try using metaphor: tell us what the feeling resembles or is like. The more specific you can be, the more able we are to provide you with appropriate and individualized care.

Ask Questions

Each time you leave our office, we want to be sure you fully understand your dental health situation and our recommendations for home care or further treatment. We want you to know what to do, how to do it and why you are doing it. As the saying goes, there are no stupid questions. So if anything is unclear, ask. If you’re curious about something, ask. Feel free to take notes. If we’ve not already provided them, ask for written instructions. (And if you want to have your spouse, partner, a friend or relative with you to help make sure nothing is missed, please bring them along!) We will do whatever we can to make sure you are comfortable and get the information you need in a way that you can both remember and understand.

Please proceed through the forms under “Enhanced Forms – Biological Dentistry.” When you finish a form, it will automatically direct you to the next form.