ONLINE PAPERWORK INSTRUCTIONS, IF SUBMITTING BY EMAIL

1. If you do not have Adobe Acrobat, Download Acrobat FREE.

2. Click on the Fillable Link to the file you want to download on this screen.

3. Download the File onto your computer by clicking the Download PDF button in the upper right corner of the screen.

4. When the file is downloaded, make sure you open the Free Adobe Reader DC app that you have downloaded first.

5. Again, Make sure that you open the file using the Acrobat Reader DC App. To do this, open the Adobe Reader DC application after downloading the file, and open a new file in the program. (Click on File, then Click on Open to browse the documents on the computer. Then select the downloaded clinic file you have downloaded in step 3.)

6. Fill out the form and then click on submit at the bottom of the form.

7. The program will have you submit the paperwork by email. The email will be automatically generated as a draft. Please press send in your selected email inbox to have your paper submitted.

8. Our team will receive the email and complete the remaining steps. If there is a question or signature missed, we may request it at the time of your office visit.

Video: How To Complete Fillable Forms Online

Referral Paperwork

This is a printable link. Click here for our New Referral paperwork.

New Client Paperwork PRINTABLE

Save time when you arrive for your appointment by printing your check-in paperwork online. This is a printable link. Click here for the paperwork.

New Client Paperwork Fillable

First, Download Acrobat FREE.

Download the file to your computer and open the file with the Acrobat Reader DC app. Then you are able to fill and submit.

Save time when you arrive for your appointment by filling in your paperwork online. This is a fillable PDF link. Click here

PHQ Questionnaire Printable

Save time when you arrive for your appointment by printing your PHQ-9 questionnaire online. Click here

Release of Information

This is a printable/fillable link. Click here

PHQ Questionnaire Fillable PDF

First, Download Acrobat FREE.

Download the file to your computer and open the file with the Acrobat Reader DC app. Then you are able to fill and submit.

Save time when you arrive for your appointment by filling-in paperwork online. Click here to fill the PHQ-9 paperwork.

SOAPP-R Printable AND Fillable

Save time when you arrive for your appointment by filling-in your check-in paperwork online Click here Then you will be able to print the file out to fill in.

OR Download Acrobat FREE.

Download the file to your computer and open the file with the Acrobat Reader DC app. Then you are able to fill and submit.

ODI Document

Save time when you arrive for your appointment by printing your ODI disability document online or filling it out using Adobe Acrobat Reader DC For Free. Click here

NDI- Neck Disability Index Document

Save time when you arrive for your appointment by printing your Neck Disability Index questionnaire online or filling it out using Adobe Acrobat Reader DC For Free. Click here

HIPAA Disclaimer- Please be aware that e-mail communication can be intercepted in transmission or misdirected. Please consider communicating any sensitive information by telephone, fax, or in person. The information contained in your email message sent to MIPM clinics may be privileged and confidential- the patient assumes all risks associated with email. We employ HIPAA Compliant email servers to ensure security.

Spine and Pain Accreditations and Associations

  • American Academy of Pain Management American Academy of Pain Management
  • American Board of Pain Medicine American Board of Pain Medicine
  • Spine Intervention Society Spine Intervention Society