Forms

Listed below are a few forms that we use for all new patients. You can decrease your wait time at the Center by downloading and printing these forms, filling them out and bringing them with you on your next appointment.

Authorization for Disclosure/Release of Health Information Form

This form doesn’t need to be downloaded and printed. Simply click the button below and you’ll be taken to a secure website to fill out the form. Fill in all appropriate fields and we will receive the form electronically after you submit it.

Contact Information for Medical History

This document can be downloaded and printed directly from our website. Clicking the “Download Form” button below will open a new window with the document in PDF form. You can then download and print the form from your web browser. Google Chrome is preferred, but not required.

New Patient Packet

Same as the above form, this document can be downloaded and printed directly from our website. Clicking the “Download Form” button below will open a new window with the document in PDF form. You can then download and print the form from your web browser. Google Chrome is preferred, but not required.

Your Pain Ends Here

Begin your journey to living a pain free life today!

Schedule an appointment — online

Or call — (770) 680-5740

You can also use the form below and we will contact you ASAP.

Contact form

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Better Pain Management is Our Mission

don’t live with pain any longer — Give us a call, email or stop by today!

info@mypaincenters.com

4905 Lavista Rd. Suite C Atlanta, GA 30084