Premier Medical is pleased to be among the first pain management offices in San Antonio to use an entirely paperless medical record system (electronic medical records). To assist in making your first visit to our office as time efficient as possible, we provide our in-take forms, here, for your convenience. Please download the following forms, complete them in their entirety, and bring them with you to your appointment. Please take additional care in completing your medical history, particularly as it pertains to pain conditions. We also highly recommend that you check your insurance plan with the Premier Pain Consultants insurance page to verify coverage.
Please Bring The Following To Your Scheduled Appointment:
- All related medical records, reports, and original diagnostic films (X-rays, MRIs, etc.).
- A valid insurance card and driver’s license. If your picture ID does not reflect your current address, we will need a recent utility bill with current address.
- Bring all medication in original containers at each visit.
- Names, addresses and phone numbers of referring and primary doctors.
- Bring COMPLETED patient information forms.
To Download Forms, Click A Link Below:
- Commercial Insurance New Patient Forms (Patient History, Payment Authorization, Controlled Substance Agreements, Office Protocol, Privacy Notice)
- Long Term Continued Agreement
- Intake Forms
- Pre-pain Procedure Medication Recommendations
- Post-Procedure Instructions
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