Patient Forms


 

We appreciate your consideration of Pain Care Boise for your healthcare needs. We strive to provide the highest quality of professional care at the best possible value. You can help us anticipate special needs by telling us more about yourself.

For your convenience you may print and complete our new patient forms. If you do not have access to a printer we can fax or mail you a copy; or you may stop in to get them.

Our providers would like to review any reports from other doctors, x-rays, MRI’s, CT scans or other tests that you may have had performed in the past relating to your pain problem.

Once we have reviewed your forms and reports and we feel we can help with your pain problem, we will contact you for an appointment. We know you have a choice when it comes to your medical care and we appreciate you choosing Pain Care Boise.

Sincerely,
The Staff of Pain Care Boise
William G. Binegar, M.D.

NEW CLINIC PATIENTS
NEW SURGERY CENTER PATIENT FORMS



All new Pain Care Boise patients please complete the following forms and present to our receptionist at your first appointment time.
 
 
Financial Agreement Form

 
Medical Allergies Form
 
 
Patient No-Show Policy
 
 
Patient Release of Medical Information
 
 

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