Your First Visit

On your first visit, we will perform a complete history and physical, with the purpose of understanding your pain and how to best treat it.

A. Initial Patient Packet (PDF)
Attached is our initial intake form, which you can print out, fill out and fax back to us.

1a. Initial Functional Restoration Packet (PDF)

2a. Initial Pain Psychology Packet-Insurance/Cash (PDF)

3a. Initial Pain Psychology Packet-Work Comp. (PDF)

4a. Informed Consent for Procedures(PDF)

5a. Follow-up Intake Form (PDF)

B. Patient Privacy Policy (HIPPA Agreement PDF)

C. BBHI
You will probably be asked to complete a test, called the Brief Battery for Health Improvement (BBHI), which helps us understand if there are any barriers to recovery.

 

Pacific Coast Pain Management Center 24902 Moulton Parkway, Suite 200 Laguna Hills, CA. 92637
P: (949) 462-0560   F: (949) 462-3910   questions@pcpmc.com