New Patient Information and Forms

We are pleased that you have chosen Consultants in Pain Management, a Tennessee Certified Pain Clinic, for your pain management care.

We are located at 2000 Stein Drive, Chattanooga TN, 37421. You can find directions to our office here on Google Maps, alternatively, if you prefer printable directions, you can find them here.

Please completely fill out each of the forms below. Carefully read all the information on each form before signing and give us as much information as possible. If you have any questions concerning any part of the forms we will be happy to go over it with you. We look forward to your appointment and if you have any questions please call us at 423-648-8480.

Please bring with you your insurance cards, all medications in the correct bottles and A CURRENT (Valid) Government Issued Photo ID. If you come to the appointment without a current (valid) government issued photo ID you will be asked to reschedule to the next available appointment allowing you time to obtain the proper identification.

Note: At Consultants in Pain Management our providers review all information received and customize a treatment plan for you which may or may not include prescribing medications at that appointment. Your treatment plan may also include an appointment with the staff psychologist before any medications will be prescribed.

Forms

New Patient Registration Form

Assignment of Benefits

Privacy Form

Patient Policies

Financial Policy

Notice of Privacy Practices

Pharmacy Assignment / Medication Pickup Authorization

Medication Agreement

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