NYC Pain Management offers patient forms online so you can complete your new patient paperwork from the comfort of your home or office. Download the appropriate forms, fill them out, and either fax them to our office or bring them to your appointment. Completing your forms in advance saves time at check-in and allows your physician to review your history before your visit.
NYC Pain Management provides downloadable patient forms for new patients, Workers' Compensation cases, auto injury claims, HIPAA authorization, insurance billing, and medical records transfer. Patients can download and print each form, complete it at home, and submit it by fax prior to their appointment or bring it in person on the day of their visit. An online registration option is also available for patients who prefer to submit their information digitally.
Pre-completed forms mean less waiting and more time with your physician.
All online submissions are encrypted and fully compliant with federal privacy law.
Your doctor reviews your history before you arrive — no starting from scratch.
Print, complete, and fax your forms or hand them to our front desk on arrival.
Print, complete at home, and fax or bring to your appointment.
Complete this form before your first visit. Covers your full medical history, current medications, prior treatments, and a detailed pain assessment.
Required for the release or receipt of your medical records. Authorizes our office to share your health information with designated parties.
Authorizes NYC Pain Management to bill your insurance carrier directly on your behalf, reducing out-of-pocket paperwork.
Designed for workplace injury claims. You'll need your claim number, employer information, and date of injury to complete this form.
For patients injured in motor vehicle accidents. Include your claim number, accident date, and auto insurance carrier information.
Authorizes the transfer of your records from a previous provider to our office so your physician has your complete health history.
Print, complete, and fax your forms to our office at least 24 hours before your appointment. Our team will confirm receipt and have your records ready for your physician.
Prefer to hand-deliver? Bring your completed forms to our front desk when you arrive. We recommend arriving 15 minutes early to allow time for check-in and any remaining paperwork.
Prefer to register digitally? Fill out this secure form and our team will contact you within 1 business day to confirm your appointment and answer any questions.
Yes. NYC Pain Management offers patient forms you can download, complete at home, and bring to your visit — or fax directly to our office in advance. Completing your forms ahead of time reduces wait time and allows your physician to review your history before you arrive.
New patients are required to complete the New Patient Intake Form, which covers your medical history, current medications, prior treatments, and a pain assessment. You will also need to complete the HIPAA Authorization Form and, if applicable, the Insurance Authorization Form.
You can bring your printed and completed forms to your appointment, fax them to our office in advance, or submit them through our secure online registration form. Our team will confirm receipt and contact you within one business day.
Yes. Workers' Compensation patients should complete the Workers' Comp Intake Form in addition to the standard new patient paperwork. You will need your claim number, employer name, and date of injury.
The intake form asks for your personal and insurance information, family medical history, current medications and dosages, prior surgeries or treatments, and a detailed description of your pain — including location, severity (0–10 scale), duration, and aggravating or relieving factors.
Absolutely. All patient information is protected under HIPAA (Health Insurance Portability and Accountability Act). Your data is never shared without your explicit written consent. Our online registration form uses secure encryption to protect your submission.
Patients injured in motor vehicle accidents should complete the Auto Injury Intake Form. This form captures your accident date, claim number, and auto insurance carrier details, which are required to process no-fault billing.
We recommend submitting or faxing your completed forms at least 24 hours before your scheduled appointment. This gives our clinical team time to review your history and prepare for your visit.
Download your forms, complete them at home, and arrive ready for your first appointment. Have questions? Our team is here to help.