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Patient Forms

The following forms are available to download and complete if you desire prior to the initial office visit:

If you are a patient who may be experiencing any TMJ Symptoms including Headaches, Facial Pain and/or Jaw Pain please fill out the following along with your history form.

If you are a patient who may be experiencing any Sleep Apnea symptoms please fill out the following along with your history form.


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Mary E. Burns D.M.D.

  • Mary E. Burns D.M.D. - 123 W. Bridge St., Suite B, New Hope, PA 18938 Phone: 215-862-2275

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