805-682-5520

Patient Information

For proper pre-procedure preparation and post procedure recovery, please review the following information and complete the forms below.

Preparing For Your Visit

To prepare for your visit, we ask that you fill out the attached Pain History Questionnaire and the Insurance Registration Forms. You can either 1) Fill out and submit forms online or 2) Download the PDF, fill out, print, and bring it with you to your first visit.

ONLINE: Fill out online form and submit.

Pain History Questionnaire Online
Insurance Registration Online

 

DOWNLOAD: Download the two PDF forms, fill out, print and bring to your first visit.

Download Pain History Questionnaire PDF
Download the Insurance Registration Form PDF

Pre-Procedure Instructions

The success of your procedure depends on the collaborative effort between you and our staff. Please read the following pre-procedure instructions by clicking on the link below

Post-Procedure Instructions

You will have to restrict your activity following the procedure Please review the following post-procedure instructions to minimize the risk of complications and give you the most benefit from the procedure.

Follow Up Visits

Please complete the following form before your next visit. You can also report the results of a procedure using this form.

Step into enjoying life again!

805.682.5520

504 West Pueblo Street, Santa Barbara, CA 93105

ThePainMD[at]painmanagementsb.com