Doctor medical center in Brunswick and Vidalia with surgery facility

For your convenience we are providing forms which you can fill out prior to coming to your first appointment. This enables you to take your time completing the two forms which will help us in the initial diagnosis of what is causing your pain.

There is also a form for your referring physician as well as copies of your rights and responsibilities as a patient.

The links below will open pdf files which you can then print. Complete the forms and either bring them to your first appointment or fax them to our Brunswick office at 912-264-1085 or to our Vidalia office at 912-537-4437. These pdf forms are opened through Adobe Acrobat Reader. If you do not have Adobe Acrobat click here for a free download.
	New Patient Paperwork Patient History Financial Policy Medical Agreement Patient acknowledgement Patient Rights and Responsibilities Referral Form - for referring physicians only

Consultants in Pain Medicine and Coastal Pain Center (Outpatient Surgical Center)
3221 Glynn Avenue • Brunswick, GA 31520 • 912-466-9111 • fax 912-466-9111 • info@docpain.com
Consultants in Pain Medicine • 1707 Meadows Lane, Suite A • Vidalia, GA 30475
912-537-4414 • fax 912-537-4437 • infovidalia@docpain.com
Hours for all offices: M-TH 8 a.m.-4:30 p.m. • F 8 a.m-12 noon

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