Contact KenmoreMyo

Dave Henrichsen, RDH, Myofunctional Therapist

Patient's Name

Parent/Guardian Name (if minor)

Preferred phone number

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I am contacting you to discuss

Tongue Thrust

Facial Rest Posture

Thumb/finger habit

Tongue/Lip Posture

Abnormal Swallow

Lingual Frenum Restriction

tongue tie

Mouthbreathing

Snoring/Sleep Apnea

Something else

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