Health Connections Intake Form
Welcome!
Dr. Stagg’s care is unique, even compared to other dentists! Our practice has an emphasis on connecting the dots of dentistry to airway, breathing, and whole-body health. We find oral and dental solutions for medical conditions!!!
In order to best help you, please look at our website to determine how we may best be of service.
We will always recommend that a ’new’ patient to our practice start with an initial visit that consists of at minimum a Comprehensive Examination. Other proposed diagnostics/ tests will incur their own charges. This enables us to determine the type of treatment that may best suit you.
IF your symptoms show that you definitely have dental, oral, airway or TMJ issues, we may also recommend an onsite 3D CBCT: a 3D radiograph showing your mouth, joints, airways and neck. Remember, we treat dental and oral conditions that may have medical symptoms downstream!
Following this initial visit, you will be asked to return for a very thorough Consultation. This is when Dr. Stagg will go over in detail your options and the order in which to proceed with your care.
If you need information regarding your Dental insurance, please note that we are a freedom of choice practice, therefore we are an Out of Network Provider. Some of our patients have insurance plans that have Out of Network benefits available. If that is your case and you’d like to utilize your insurance, I suggest you contact your insurance company to see if your particular plan has any out-of-network benefits available.
- In order to best schedule you, please complete this intake form.
- Upon receipt, our new patient coordinator will give you a call at their earliest convenience.
- DO NOT fill out this form if this is an emergency.
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Need Dental Services?
Call: (321) 777-2797
Hour of Operations
Mon – Thurs 9AM – 5PM
What Our Patients Are Saying
Real stories from patients who discovered how life-changing Health Connections Dentistry® holistic dentistry can be.
Nerissa Johnson
Dr. Stagg and her fantastic staff have been wonderfully instrumental in the success of our daughter's airway and orthodontic correction. We would highly recommend her to everyone! 
Tami Smith
Dr Stagg and her team are amazing. Always happy and kind... always pay attention to detail and go above and beyond for their patients. Dr. Stagg's knowledge is very impressive and you know you are in good hands.
Laura Aho Parsons
I came to get help from Dr. Stagg as an emergency case, referred by my Dentist. Dr. Stagg and her team did extensive testing to get to the cause of my pains, which turned out to be TMJ Disorder. But she also discovered I had Sinus issues and referred me to an ENT specialist, for an emergency appointment.
She and Dr. Malis were able to discuss my case prior to my appointment so we were primed for what needed to happen first and soon--sinus surgery! Later she referred me to a Cranio-Sacral specialist to help with musculature and skeletal issues. Dr Stagg has amazing intuition, is an artist sculpting each apparatus, a natural healer, uses all the latest technologies and has a staff as professional, yet compassionate, as she is to handle every step of the individualized protocols needed for each unique patient. She is a rare Find indeed.
Cecile Blunt
Who knew that my jaw and sleeping problems could be addressed by the expansion of this 83 year old mouth? Well, Dr Stagg knew!! The ALF and lower orthotic are improving my situation almost daily for 7 months now. She and her staff are wonderful!!!
Alexandra Poolt
I had a very pleasant experience with Dr. Stagg and her excellent team all the way through the assessment process and into the treatment. I finally have a better understanding of my teeth, the mouth & the tongue and how all interconnects to show a picture of my overall health. If you have been searching for answers beyond standard dental care, give her a try!!!
Lisa B
Before my treatment I found myself to have severe fatigue, no motivation to do anything, and procrastination on the smallest things. The first day I wore my orthotic, my pain in my neck and upper back diminished. I find myself awakening in the morning feeling like I got a good night sleep and I am able to fall asleep with no problem. My fatigue has lessened tremendously. I have and would recommend this treatment to friends. My life has become more enjoyable being pain free.
Cristiano V
Before seeing Dr. Stagg, I struggled for years with constant fatigue, poor sleep, and jaw tension I didn’t understand. She discovered that my airway issues, sleep apnea, and TMJ were all connected — and that the root cause was in my mouth. Through her precise, gentle treatment, my breathing improved, my sleep became deep and restorative, and the daily pain I lived with disappeared. It completely changed my health, energy, and focus. I can’t thank you enough!.
Dr. Charles D. Dusch, Jr.
Outstanding customer care! Dr. Stagg kindly worked me into her busy schedule to correct an unexpected issue and gave me her full attention. Her amazing staff are also so friendly, caring, and competent. I strongly recommend this practice!
Dr. Larisa Scott
Amazing! Staff was very welcoming. Dr. Stagg knows her stuff. She looks at you from a while body perspective. Honestly it is such a privilege to have an amazing dentist in the area.
