Gina Liggio Maestri, DDS

Medical History

Although dental personnel primarily treat the area in and around your mouth, your mouth is a part of your entire body.  Health problems that you may have, or medication that you may be taking, could have an important interrelationship with the dentistry you will receive. 

Fill out our Medical History Form below, or click here to download a copy to print and bring into our office.

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No



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No

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No

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No

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No

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No


Asprin
Penicillin
Codeine
Local Anesthetics
Acrylic
Metal
Latex
Sulfa drugs


Phen-Fen.
Redux.
Both.
No.

Yes
No

Aids/HIV Positive
Alzheimer's Disease
Anaphyllaxis
Anemia
Angina
Arthritis/Gout
Artificial Heart Valve
Artificial Joint
Asthma
Blood Disease
Blood Transfusion
Breathing Problem
Bruise Easily
Cancer
Chemotherapy
Chest Pains
Cold sores/fever blisters
Congenital Heart Disorder
Convulsions
Cortisone Medicine
Diabetes
Drug Addiction
Easily Winded
Emphysema
Epilepsy or Seizures
Excessive Bleeding
Excessive Thirst
Fainting Spells/Dizziness
Frequent Cough
Frequent Diarrhea
Frequent Headaches
Frequent Headaches
Genital Herpes
Glaucoma
Hay Fever
Heart Attack/Failure
Heart Murmur
Heart Pacemaker
Heart Trouble/Disease
Hemophilia
Hepatitis A
Hepatitis B or C
Herpes
High Blood Pressure
High Cholesterol
Hives or Rash
Hypoglycemia
Irregular Heartbeat
Kidney Problems
Leukemia
Liver Disease
Low Blood Pressure
Lung Disease
Mitral Valve Prolapse
Osteoporosis
Pain in Jaw Joints
Parathyroid Disease
Psychiatric Care
Radiation Treatments
Recent Weight Loss
Renal Dialysis
Rheumatic Fever
Rheumatism
Scarlet Fever
Shingles
Sickle Cell Disease
Sinus Trouble
Spina Bifida
Stomach/Intestinal Disease
Stroke
Swelling of Limbs
Thyroid Disease
Tonsillitis
Tuberculosis
Tumors or Growths
Ulcers
Veneral Disease
Yellow Jaundice

Education is key

Education is a lifelong journey and a truly dedicated family dentist never stops learning. To this end, Dr. Gina Liggio Maestri DDS obtains 75-80 hours of continuing education every year, twice the state’s requirement. In addition, Dr. Maestri and her team focus on educating our patients through hands-on techniques and the open sharing of information. Well-informed patients tend to make better decisions when it comes to at-home dental hygiene and lifestyle choices that impact oral health. If you have any questions about family dentistry or feel that you need some professional guidance, please feel free to ask.

Gina Maestri - Lafayette, LA
Gina Liggio Maestri, DDS Family Dentistry

Welcome

Welcome to exceptional family dentistry in Lafayette. Dr. Gina Liggio Maestri DDS and her team of dedicated dental professionals are here to provide you and your family with a level of caring clinical excellence you’ve never experienced before. From our state-of-the-art technology to our many comfort amenities, we have everything you need to feel relaxed while you enjoy gentle dentistry in Acadiana.

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Find Us @

1601 Kaliste Saloom Road
Lafayette, LA 70508

337-704-2126
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