We aim to exceed expectations in all of our services. Quality is at the center of all of our work. Our team members complete their jobs with accuracy and care, no matter the size of the task.
Patient Resources
Are you looking for new patient paperwork, a records release form, or our treatment agreement? You can access those forms below.
If you can’t find what you’re looking for or you have questions, please call us at 614-383-6450.
New Patient Forms
Please complete your new patient paperwork prior to your first appointment, as we need this information to gain an understanding of your condition and develop an individualized plan of care for you.
We offer several options for completing this paperwork:
- Click on this link to submit your paperwork electronically.
- Click on this link to print your paperwork.
- Call our office, and we can mail a paperwork packet to you.
Please remember to bring your photo ID and insurance card to your appointment. We look forward to meeting you.
Telemedicine Waiver
If you are requesting telemedicine services, please fill out this telemedicine waiver and Opioid Agreement and return them to our office.
Treatment Agreement Form
We require all patients to sign this form, regardless of whether they are using medications to manage pain symptoms. Please complete and sign this form and bring it with you to your first appointment.
Medical Records Release Form
If you need a healthcare provider to share your records with us, please complete and sign this form and give it to your doctor.
Pay Your Bill Online
If you need to pay your bill from Integrated Pain Solutions or Gemini Surgery Center, you can do so via our patient portal.
Frequently Asked Questions
Do you have questions about insurance, our practice, or the services we offer? Take a look at our FAQ page – you may find the answers you need.
