WHAT DO I BRING WITH ME?
Please bring a photo ID, your insurance card and CASH, VISA, MASTERCARD, AMERICAN EXPRESS, DISCOVER card with you when you visit our clinic.
Please download the following Patient
Registration Packet and have completely filled upon your arrival for your appointment.
CHRONIC PAIN MANAGEMENT PATIENTS
Chronic pain management patients are required to have medical records of previous medical history to validate your chief complaint of pain upon arrival. Please pay close attention to page 16 (medical release form) in the packet. The medical release form can be filled out and faxed to us at (888) 812-4235 or scanned and emailed to us prior to your visit so that we may have time to retrieve your records from the respective entity at email@example.com.
Certain medical records must be in our hands and reviewed by our medical director before an appointment is scheduled for you. These records include recent office visit notes with your primary care physician or other physician(s) who have been treating the condition for which you are requesting an appointment to see us, a complete list of current medications, notes from previous surgeries/procedures related to your pain, radiology reports from X-ray, MRI, or CT exams (films are helpful, as well), and insurance information. A referral from your primary care physician is required if deemed necessary by your insurance carrier. Additionally, if you have been treated at a pain facility before, we will need to have those records for review.
Only once we have these records on hand and reviewed will we be able to schedule an appointment for you. No patient will be scheduled for an initial visit without providing all of the appropriate records first.
It is your responsibility to make arrangements to get us the complete list of records; our office staff is not responsible for procuring your medical records although we can attempt to do so once we have your signed and validated medical release form (pg 16 of Patient Registration Packet).
DISABILITY FORM LETTERS and Medical Disability Consultation:
Our requirements for the completion of disability forms or letters are listed below:
- There will be a charge that must be paid prior to the completion of the form/letter. This charge ranges from $50 to $500 depending on the complexity of the request. The charge for most forms is $50.
- Ten working days will be required for the completion of the form/letter.
- The completion of some forms/letters may require an office visit if additional assessment is required.
- We reserve the right to refuse to complete a form if it requests information that we do not have as a part of your treatment with us.