New PAIN Patient Paperwork

Please complete the attached paperwork prior to your first visit. Bring this paperwork, your insurance card and photo ID, and recent x-ray or imaging reports.

New MAT Patient Paperwork

This paperwork is for new patients seeking medically assisted treatment for addiction. Please print and complete this packet and bring it with you to your first visit.

Release of Medical Records

We have partnered with MediCopy to provide accurate and timely delivery of your medical records. Please complete this form and send to MediCopy via email or fax.

Good Faith Estimate Request

Request an estimate for self-pay or non-covered services.