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New Pain Management Patient Forms

Welcome to Tallahassee Neurological Clinic
Department of Pain Management

Please be advised that your first visit is for initial consultation only. You and the doctor will decide on the best treatment plan for you. Please call us prior to your appointment to verify that we have received your records from your referring physician. Please do not bring children to your appointment. The doctor needs your undivided attention at this visit. Please call us to reschedule if you do not have alternate care for your child.

A complete exam will take approximately 30–60 minutes, depending on the reason for the consultation. A report will be sent to your referring physician. Please bring your current medication(s) in the original bottle(s) for our doctors to verify the name and dosage. Consultations range in price depending on the complexity of the examinations, diagnosis and treatment options, and time involved. All co-pays and deductibles are due at the time of your appointment.

Please note that we accept assignment only for Medicare, Medicaid, Workers’ Compensation, and some HMOs. (You may contact us to verify coverage by your plan.) If your injury is related to an auto or work accident, your auto insurance agent or worker’s compensation adjustor should have made the appointment and furnished our office with all related billing and claims information. If you have any concerns about this process, please contact your agent or adjustor. If there is an attorney involved in your case, please notify the receptionist.

Below are all necessary patient forms that you should complete prior to your appointment. Please complete each form to the best of your ability. Also, please remember to bring your insurance cards and driver’s license for us to copy. Please do not hesitate to call our office if you have any questions.

Tallahassee Neurological Clinic
Department of Pain Management

Call Us (850) 877-5115