301 Southeast 16th St.
Fort Lauderdale, FL 33316
(954) 462-5252

Patient Forms

Snoring and Sleep Apnea form:

(use in lieu of registration form if you are seeing Dr. Kodish for sleep related issues)
Please follow instructions and answer every question that applies

TMD, Migraines, Headache form:

(use in lieu of registration form if you are seeing Dr. Kodish for TMD,Migraine, and Headache related issues)
Please follow instructions and answer every question that applies

New patient registration forms packet: