If you did not receive the forms below during your office visit, please review each form and print the Acknowledgement of Receipt form and bring with you during your next office visit.

• HIPAA Privacy Notice
  Click here to review our HIPAA privacy notice regarding patient privacy.


• Patient Bill of Rights
  Click here to review your responsibilities and rights as a patient.


• Advanced Directive
  Click here to read the Advanced Directive Policy.


• Get Involved in Your Care
  Click here to read about how you can get involved in your care.


• Prevent Surgical Site Infections
  Click here to learn how you can prevent surgical site infections.


• Acknowledgement of Receipt
  Please print and fill out this form and bring it with you the day of your surgery.

Pain Management

• Pain Questionnaire - (Initial pain management consultation only)
  Please print and fill out this form and bring it with you.
  
  
• Pain Follow-Up Visit - (All pain follow-up visits must complete this form)
  Please print and fill out this form and bring it with you for your follow up.

Surgical patients and pain mangement patients (i.e., injections, pump placement, etc.) must complete the forms below.

• Patient Medication Inventory Form
  Please print and fill out this form and bring it with you the day of your surgery.


• Pre-Operation Surgery and Anesthesia Checklist
  Please print and fill out this form and bring it with you the day of your surgery.