If not picked up at birth children with significant tongue ties can't start to fall behind their peers because they cannot speak properly.

Lip Tie Quick Contact

QUICK CONTACT - LIP TIE

Patient Name(Required)
* Must match name on Medicare card.
DD slash MM slash YYYY

Who diagnosed the Lip Tie?
INFANT LIP TIE
Please enter YES into any of the following issues affecting your child.
Latching issues
Falling sleep when feeding
Not gaining weight
Pain for mother
Other, please list
Fussy
Falling off the breast
 
CHILD TO ADULT LIP TIE
Please enter YES into any of the following issues affecting the patient.
Gap between the two front teeth
Fussy eater
Other, explain
 

Do you want to book an appointment now?(Required)
If yes, which location do you want to attend:(Required)
If there is anything else you believe we need to know please document here.