New Patient

  • New Patient Packet

​HIPPA

  • HIPPA – Notice of Privacy Practices (English/Spanish)

  • HIPPA Compliance Form

  • HIPPA Compliance Plan

  • United Interventional Pain Management – Notice of Privacy Practices

Others

  • Worker’s Compensation Form

  • Worker’s Compensation Information Form

  • C4

  • Accident/Injury Detail Form

  • Release of Medical Information

  • Pain Questionnaire

  • No Fault Application

  • No Fault Information

  • Minimally Invasive Treatment

  • Medical Reconciliation

  • 诊所用同意书2014

  • 疼痛相關問卷–繁体(诊所用)