New Patient Information
The staff of Southern Illinois Pain Management would like to welcome you as a new patient to our facility.
Here are links to several forms you will need to complete and mail back to our office one(1) week prior to your appointment, or as soon as possible.
- New Patient Registration Form (requires Adobe Acrobat)
- New Patient Questionnaire (requires Adobe Acrobat)
The day of your appointment you will want to wear comfortable clothing and please bring the following with you:
- All medical records
- All X-rays or MRI films
- Any reports pertaining to your medical condition
- All medications (both prescription and nonprescription), which you use on a regular basis
- Insurance cards / billing information
Having completed forms and all necessary information helps to alleviate a prolonged waiting time during your first visit. You will also be filling out other paperwork on the day of your appointment, so we ask that you arrive a minimum of 30 minutes before your scheduled appointment time.
THE PHYSICIAN CANNOT SEE YOU WITHOUT THIS INFORMATION!
If for any reason you are unable to keep your scheduled appointment, please contact our office. Thank you very much for your cooperation!
Please read about our Office Policies and General Information before you attend your appointment.
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