APPOINTMENT INFORMATION

Remember to bring these items with you for your first appointment. Self referrals are accepted but your first visit will be a consultation. It will be at the providers discretion whether or not they treat or write a prescriptions on that day. A consultation is done to decide if you are a good candidate for pain management and if so, to start building your individualized treatment plan.

Completed Patient
Information Form

Copy of
Insurance Card

Most Recent
Image Reports

List of Current
Medication

RESOURCES

Incoming Medical Records Request

To authorize CPS to request your medical records, click download on the button below and please fill this form.

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Outgoing Medical Records Request

To release your medical records, click download on the button below and please fill this form to release your information.

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Notification of Patients Right to Privacy

This notice describes how medical information about you may be used and disclosed and how you can get access to this information. Please review it carefully.

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New Patient Packet

In order to make your experience with CPS as easy as possible, we are happy to provide our new patient packet in advance, so you can fill it out at your own convenience before you arrive for your appointment.

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Patient Satisfaction Survey

Are you happy with our service? Did we meet your expectations? Are you satisfied with how we conduct our services? In CPS, patient satisfaction is our number one priority. Please let us know your thoughts about us by joining the survey. You will receive our satisfaction survey after your appointment, once every 6 months.

Referral Form

Are you a new patient? Some Insurance plans will require a referral from you Physician. Click on the button below to download a Referral Form to give to your referring doctor.

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CPS is an In-Network Provider with Most Insurance Companies

A self-pay option is available for uninsured patients only.