Patient Info

INNOVATIVE SPINE CARE CAN HELP YOU

Many people suffer pain in the spine from the neck all the way down the low back. Pain combined with weakness, tingling, or numbness in the arms and legs is also common. This can be the result of the aging process or the result of an injury during everyday activities, slip & falls, athletic events, and auto accidents.

OUR PROCEDURES ARE PERFORMED IN A SURGERY CENTER

Please fill out each and every form in the packet below. These forms encompass all of the demographic information that is needed. It also includes all of the medical information that the physician typically needs to understand your history and put that together with your physical exam to come to the right diagnosis and suggested treatment. Filling out these forms at your leisure before presenting to the office will save you time as the staff and physician will not be needing to ask you so many questions.

    1. New Patient Welcome Letter
    2. Patient Demographics
    3. Patient / Physician Agreement
    4. Assignment of Benefits
    5. Medical Records Release
    6. Pain Management Agreement
    7. Notice of Privacy Practices
    8. Patient Acknowledgement form
    9. Patient Pain History
    10. Medical History
    11. Patient Questionaire
    12. Physical complaints

(This file includes all of the above documents)

    1. Full Patient Packet

(This file includes all of the above documents)

Request Appointment
(813) 920-3022

Get Directions
Tampa, FL

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