The forms contained here are for the use of our new and existing patients. By printing, completing and bringing the appropriate forms with you to your appointment , you will not only help us be more efficient,you will also assure the accuracy of your treatment
*It is also very important to bring a list of all currrent medications to each appointment.
New Patient Packet: If you are a new patient, please print this form and fill it out before your first appointment. Don't forget to bring it with you!
HIPPA Acknowledgment and Release Packet: Please print, read and sign these HIPPA Acknowledgment and Release forms and bring then to your first appointment.
Demographics Update: If any of your personal information has changed since your last visit, please print this form and fill it out before your next appointment.
Insurance Plans Accepted: This document contains a list of insurance plans that the office accepts.If you do not see your insurance listed, please contact your plan and check if we are currently contracted with them..
Medication History Form: If requested by Dr. Pace or her staff to provide a history of the medications you have used and/or are currently using, please fill out this form and bring it with you to your next appointment.
Rheumatoid Arthritis Update: If applicable,please print this form and fill it out the day of your next appointment.
Fibromyalgia Update: If applicable,please print this form and fill it out the day of your next appointment.
Patient Medical History Update: Please print and fill out this form and update your medical information the day of each appointment.
Brief Pain Inventory: If you are being seen for chronic pain,please print and complete this form the day of your next appointment.
Carolyn Pace,MD FACR
2034 East Southern Ave, Suite P
Tempe, Arizona 85282