Stacks Image 31054

Patient Forms

8080 Academy Rd. NE, Suite A
Albuquerque, NM 87111
Tel: (505) 247-9700
Fax: (505) 247-4333
frontoffice@nmpainsolutions.com

THESE FORMS CANNOT BE FILLED IN OR SUBMITTED ON LINE.

YOU MUST DOWNLOAD THEM, FILL THEM OUT, AND BRING THEM WITH YOU TO YOUR APPOINTMENT.

Your first appointment is an evaluation appointment. Until we see you and evaluate your needs, we will not be able to assess whether we can treat you as a patient at Pain Solutions.

Prior to your first visit, we ask that you download the registration forms listed below and bring them with you to your appointment. At that time you must also bring your insurance cards so that we may copy them for our files. Please note that any copayment or coinsurance will be due at the time of service.

Before our providers can accurately diagnose and treat your pain, we must have all of your relevant records over the last 3 years. Relevant records are those records that refer to your symptoms.

Stacks Image 31018
Stacks Image 23270

Such records include the following: all MRI, CT scans, and X-ray reports, (we need the reports, the actual images are not necessary), all documentation of medical encounters concerning your symptoms, as well as a list of all medications, vitamins or other supplements you are taking.

We ask you to obtain these records and have them in our office forty-eight (48) hours prior to your scheduled appointment. If we do not receive the records in time for our providers to review them, we will call you to reschedule your appointment.

Please Review & Fill Out The Forms

There are SIX (6) forms. All must be completed before your first appointment. You cannot fill them out on line. Please download them, fill them out, and either mail them or bring them with you to your appointment.

We use cookies and other tracking technologies to improve your experience on our site, analyze site traffic and understand where our audience is coming from. Personal information is not tracked or maintained. Your continued use of this site indicates your acceptance of this practice