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Tel: 412-782-1500

PainMed PC

Specializing in Evaluation & Treatment of Chronic Pain

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Patient Forms

These forms are needed at the time of your appointment.

Please review, print and complete these forms and bring with you to your first appointment.

If you are unable to complete prior to your appointment, we will have a copy for you at the office and ask that you arrive at least 15 minutes prior to your appointment to complete.

The forms include:

  • Assignment of Benefits
  • Authorization for Release of Protected Health Information
  • Patient Intake Form
  • Privacy Notice

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PainMed P.C.

Main Telephone
412-782-1500

Fax: 412-828-3429

Admin. Office/Correspondence & Billing
434 Allegheny River Blvd
Suite 203
Oakmont, PA 15139

Locations

Greensburg
438 Pellis Rd
Greensburg, PA 15601

Uniontown/Dunbar
Health First Medical Center
1829 University Drive
Dunbar, PA 15431

Monongahela
121 West Main Street
Monongahela, PA 15063

Gibsonia
5476 William Flynn Hwy
Gibsonia, PA 15044

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