Patient Forms

In an effort to save time at your next appointment, please print, complete and bring the following form to your scheduled appointment at one of the Beaumont pain medicine locations:

Patient Outcome Tool and Questionnaire (PDF)

The link below is the patient medication instruction guide. You may download and print this document as a reference to help you understand how your current medications may be affected by your treatment. If you have additional questions, call the pain medicine phone nurse at any time:

Patient Medication Instruction Guide (PDF)

If you will be receiving long-term controlled substances therapy, you need to print and complete the following forms to your next scheduled appointment:

Consent for Chronic Opioid Therapy (PDF)
Long-Term Controlled Substances Therapy for Chronic Pain Agreement (PDF)