Thank you for selecting Pain Consultants of Arizona in Phoenix and Chandler for your pain management care. To schedule an appointment, please call us at (480) 222-PAIN (7246), or use our online appointment request form.
Patient Forms
Once you have made your initial appointment, you may pre-register by downloading, printing, and completing the forms below. Please be sure to bring them with you to your first visit. Completing the forms prior to your visit will help speed up the new patient registration process.
Downloadable Forms:
- New Patient Registration – Demographics and Insurance
- Patient History Form
- Pain Treatment History Form
- Confidential Communications Form
- Disclosure Authorization (To PCA)
- Disclosure Authorization (From PCA)
- Patient Waiver for Non-Covered Services
Please note: It may take a few minutes to load the forms if you are using a slow internet connection. If you are unable to view the forms, you may need to download Adobe Acrobat for free by clicking on the icon below.
Practice Policies
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