DOCTOR'S REFERRAL FORM
TMJ, Cranial, Facial & Mandibular Pain
Obstructive Sleep Apnea
www.DrPatRichard.com
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I am available to assist your patients. My treatment will supplement your work. Should you have any questions regarding treatment or diagnosis, feel free to call me at 203-254-8080.
 
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Is this consult urgent ?
Craniofacial Pain Jaw locking, popping
Ear pain/stiffness Headaches: Cluster, Migraine
Facial drooping from a stroke Facial numbness
Internal derangement of the TMJ discs Airbag injury
Trigeminal nerve contusions Reflex sympathetic dystrophy
Cervicogenic headaches (from disc herniations) Ear pain from air travel
Other related conditions   Obstructive Sleep Apnea
 
 
Patricia A. Richard, M.D., D.M.D.
1735 Post Rd - Unit 6, Fairfield, CT 06824
Tel: 203-254-8080 Fax: 203-256-1330
NPI # 1164639399
 
Directions to Dr. Richard's Office
 
From New Haven (or coming from the north):
I-95, Exit 21 (Mill Plain Road). At bottom of ramp, go left, then under the thruway and under the railroad tracks. At traffic light go left onto Post Road, second driveway on right is 1735 Post Road, Colonial Village (red brick building). Park in rear, first floor, Unit 6.From Norwalk, Stamford, New York (or coming from the south):Same as above except at bottom of ramp at Exit 21 go right.