Get Chronic Pain Management - Colorado Brain Amp Spine Institute - Cbsi

This guide provides clear instructions for users on how to complete the Chronic Pain Management - Colorado Brain Amp Spine Institute - Cbsi form online. By following these steps, you can efficiently provide the necessary information for your pain management treatment.

Follow the steps to complete your Chronic Pain Management form online.

1. Press the ‘Get Form’ button to obtain the Chronic Pain Management form, which will open in the editor.
2. Begin by filling in your name, referring provider, and primary care provider information in the designated fields.
3. Enter your age and date of birth as prompted. Indicate your dominant hand and gender by selecting the appropriate checkboxes.
4. Evaluate your overall health from the options provided and mark only one box to indicate your perceived health status.
5. Identify your chief pain complaint by marking the appropriate option, and list any additional pain complaints as applicable.
6. Provide details about when your pain began, the potential causes, and its frequency by selecting the suitable options.
7. Indicate the times your pain is typically worse and rate your current, worst, and least pain severity on a scale provided.
8. List any factors that may increase, decrease, or cause no change to your pain and outline where your pain is located using the provided letters.
9. Assess your functional abilities and cope with pain by rating your capabilities in various activities on the provided scale.
10. Report any associated symptoms, previous tests, and treatments received, fulfilling each section according to your experience.
11. List current medications and their effectiveness, as well as any side effects experienced from pain medication.
12. Answer questions regarding your past pain management specialists, lifestyle, and psychiatric history as relevant.
13. Provide your anesthesia and pain procedure history, noting any reactions or issues you have encountered.
14. After completing all sections, review the information for accuracy. Save your changes, download the form, or print and share it as needed.

Complete your Chronic Pain Management - Colorado Brain Amp Spine Institute - Cbsi form online today!