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New Patient Forms

New Patient Forms (PDF format) are available so that you may fill out the forms at your convenience to prepare for your visit or procedure at the Comprehensive Centers for Pain Management.

We recommend that you download and complete these forms before your appointment.

Also, please bring all of your pain medications (actual bottles) for the nurse or physician to review.

Click Here to download New Patient Packet

Or you can download each section individually below

New Patient Packet

Notice Privacy Acknowledgement

Summary Joint Privacy Practices

Disclosure

Health Disclosures

 

Pain Management Appointment Letter

West Central Surgical Center Patient Registration Form

Advanced Directive Information

Opioid Treatment Fact Sheet

Chronic Pain Agreement

 

 

 

 

 

 

 

 

 

 

 

 
 

 

 

 
 
© Comprehensive Centers for Pain Management 1.877.446.6724
The Comprehensive Center for Pain Management at Meijer Drive 3400 Meijer Drive Toledo, OH 43617
The Comprehensive Center for Pain Management at Bay Side 846 S. Coy Rd. Oregon, OH 43616