Patient Forms
Get Started
If you’re in need of neurology treatment for sleep disorders, pain management, or other neurological disorders, our team at Neurosleep & Pain Management Center in Fort Gratiot, MI, is here to help. We provide comprehensive diagnosis and treatment for a wide range of neurological conditions, including sleep apnea, chronic pain, Parkinson’s disease, multiple sclerosis, neuropathy, epilepsy, and more. Simply give us a call and fill out our patient forms below to get started.
Patient Forms
- Acknowledgment of Receipt of Notice of Privacy Practices
- Authorization for Use or Disclosure
- Authorization to Release Information
- Authorization to Release Medical Information
- Designate Form
- Patient Profile
- E-Prescribing Consent
- Patient Demographics
- EEG Patient Information
- ELECTROMYOGRAPHY EMG and NCS Patient Information
- Trigger Point Injections Patient Information
- Neurosleep Center Greater Occipital Nerve Block Patient Information
Take a Pain Risk Assessment Test
Not sure where to go from here? Take our pain risk assessment test, then contact our office to make an appointment. Click the link below and enter the access code to take the test.