Pain Management Patients

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Patient Information

To better serve you and our other patients, we ask that you complete the forms listed below in their entirety prior to your first appointment.

Procedure Authorization Form

Pain Management & Prescription For Narcotic Medication

Screen & Opioid Assessment For Patients with Pain

Pain Survey

Please bring these items to your scheduled appointment:

  • Insurance card
  • Picture identification (accepted forms of ID include: driver’s license, state ID card, student ID, or passport)
  • Medication bottles from your current prescriptions
  • Medical records, including MRI reports, X-rays, laboratory tests and office notes from other medical facilities where you have received treatment. (These are a critical part of the evaluation.)