Keeping detailed and complete health records is important. Here you will find a selection of forms that may be beneficial. Having your information written down prior to your appointment can be beneficial to both you and your physician’s office. They will require that you complete their standard forms, but if you have all of the information written down prior to your visit, it will save you time and eliminate the possibility of forgetting some information. You can also have the office make a copy of your records for their files. Be sure you retain the original for future use.

Suggestions  (how to be prepared for your visit to the pain specialist)

Daily Health Diary (keeping a daily record can be very beneficial in helping your physician evaluate your problems)

Medication Information (use this form to list all medications that you take)

Pain Assessment (use this form to provide detailed information about your pain)

Assessment for Fibromyalgia (use this form if you have or suspect you have Fibromyalgia)

Pain Scale

Foods That May Trigger Pain (a list of food that are considered Vasoconstrictive foods)

Headache Trigger Foods (foods to avoid for some types of headaches)

Simply click on each form to download in PDF format

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