This section of the website will allow you to view, print and complete all required forms before you visit PainCARE. You may either: print each form and fill it in by hand and bring the papers to the PainCARE office before your appointment; or, fill out the forms online and have the information sent (securely) to PainCARE's office. Printable documents are available in .pdf file format. To view these files, you will need Adobe® Acrobat® Reader. The free downloadable version is available here.
 

 

Attention Patients:

If one or more of the following pertain to you as a patient, your appointment may need to be changed.

  • Recent Work-related Injury.
  • Currently taking blood thinning medication.
  • Currently using an antibiotic.
  • Fever.
  • Have had a flu shot within the past 7 days

Please call the office immediately to see if changes need to be made.

Click below to enter the page.


Patient Information Forms
If you have any questions regarding the form you are to fill out, please contact us.
Patient Information Form
Initial Patient History Form
General personal and insurance information. Asks specific pain-related questions:
Symptoms? Medications? etc.

Adobe Acrobat (Printable)

Adobe Acrobat (Printable)

Online Submission (Electronic - Disabled) Online Submission (Electronic - Disabled)
 
PainCARE Office Policy
Patient Care Policies
Rules, regulations, insurance, and financial information.
Patient-specific policy information.

Adobe Acrobat (Printable)

Adobe Acrobat (Printable)

Online Submission (Electronic - Disabled) Online Submission (Electronic - Disabled)

Descriptions of Procedures
The following documents explain procedures offered from PainCARE.

Diagnostic Facet Injection
Epidural Steroid Injection

Adobe Acrobat (Printable)

Adobe Acrobat (Printable)

 
Laser Therapy
Nucleoplasty

Adobe Acrobat (Printable)

Adobe Acrobat (Printable)

 
Radiofrequency Medial Branch Neurolysis
Sacroiliac Joint Injections

Adobe Acrobat (Printable)

Adobe Acrobat (Printable)

 
Spinal Decompression
Stellate Ganglion Injection

Adobe Acrobat (Printable)

Adobe Acrobat (Printable)

 
Transforaminal Epidural Steroid Injection
Trigger Point Injection

Adobe Acrobat (Printable)

Adobe Acrobat (Printable)

 
Discography
Synvisc

Adobe Acrobat (Printable)

Adobe Acrobat (Printable)


Post Procedure Instructions
The following documents explain post-procedure instructions for PainCARE patients.
Post Procedure Instructions
Diagnostic Facet Injection

Adobe Acrobat (Printable)

Adobe Acrobat (Printable)

 
Intercostal Nerve Block
IDET

Adobe Acrobat (Printable)

Adobe Acrobat (Printable)

 
Nucleoplasty
Spinal Cord Stimulator

Adobe Acrobat (Printable)

Adobe Acrobat (Printable)

 
Stellate Ganglion Block
Thoracic Discogram

Adobe Acrobat (Printable)

Adobe Acrobat (Printable)


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