Patient Forms

Thank you for your interest in Western Mass. Endodontics, P.C., a dental practice dedicated exclusively to endodontic care.

We are specialist members of the American Association of Endodontists. We look forward to being of service to you. Our expert team, led by respected endodontic specialists and an experienced endodontic staff provide the highest standard of professional care in a friendly, comfortable environment. We hope that the information provided here answers many of your questions about endodontic treatment. If you would like additional information, please don’t hesitate to contact us at any of our locations.

Below are forms that you can download, print, fill out and bring with you to your next appointment:

Your First Visit

Your initial appointment will consist of a consultation explaining your diagnosis and treatment options. Occasionally, treatment can be done the same day as the consultation. However, a complex medical history or treatment plan will require an evaluation and a second appointment to provide treatment on another day.

Please alert the office if you have a medical condition that may be of concern prior to surgery (i.e. diabetes, high blood pressure, artificial heart valves and joints, rheumatic fever, etc.) or if you are on any medication (i.e. heart medications, aspirin, anticoagulant therapy, etc.) or require medication prior to dental cleanings (i.e antibiotics, for pre-med.)

Please assist us by providing the following information at the time of your consultation:

• Your referral slip and any X-rays if applicable.
• A list of medications you are presently taking.
• If you have dental insurance, bring the necessary completed forms. This will save time and allow us to help you process any claims.

Scheduling

Western Mass. Endodontics, P.C. is open Monday through Friday from 8 a.m. until 4:45 p.m. A doctor is also on call 24 hours a day. We will schedule your appointment as promptly as possible. If you have pain or an emergency situation, every attempt will be made to see you that day.

We try our best to stay on schedule to minimize your waiting. Due to the fact that our practice provides surgical services, various circumstances may lengthen the time allocated for a procedure. Emergency cases can also arise and cause delays. We appreciate your understanding and patience.

Please contact one of our offices with any questions or to schedule an appointment.

Patient Survey

We at Western Mass Endo are always striving to provide the highest quality of care. We feel we could get the best result if we asked you directly about your opinion on certain matters. Therefore, we asking for your assistance in completing this confidential Online Patient Survey. We are excited to learn new ways to make your experience in our office better and we thank you for your assistance.

Click Here For Patient Survey