Thank you for choosing Central Florida Pain and Rehab Clinic for your acute and chronic pain needs. You can feel confident knowing you have selected a highly qualified team of pain specialists in Winter Park.
New patients can learn everything they need about their first visit by reading this page. You will find directions to our office, details about what to expect at your first visit, and our practice mission.
We encourage you to print and complete the registration forms conveniently provided below in advance of your first visit to save time.
Our practice is working together to realize a shared vision of uncompromising excellence in pain management.
To fulfill this mission, we are committed to:
- Listening to those we are privileged to serve.
- Earn the trust and respect of patients, profession and community.
- Exceed your expectations.
- Ensure a creative, challenging and compassionate professional environment.
- Strive for continuous improvement at all levels.
If you are a New Patient and want to schedule an appointment with us, we will need to obtain all your medical records related to the reason of your appointment first, that will help our Physician gives you an accurate diagnosis to your problem.
In order to do so, please download the Medical Records Request Form, sign it and fax it to our office at (407) 673-1442. Once we receive the signed form, someone from our office will get in contact with you within 48 hr.
HELP THE OFFICE CREATE A PAPERLESS ENVIRONMENT!
In an effort to cut down on paper waste, and to simplify the process in which your paperwork is received, our office has made the choice to go "paperless". You can either fill the forms on your computer, print and bring them with you to your appointment, send through fax at (407)-673-1442 or email to our office by clicking here. A blank form can also be printed and filled out by hand.
In order to use your time productively, please complete the following forms and submit them prior to your appointment or bring them with you.
To properly complete the forms:
- Open the form from our website by clicking each form's link.
- Complete all applicable fields.
- Once completed, print the documents if you decide to fax them or bring them with you, or save them on your desktop to send through email.
- To save the forms on your desktop, just click each form's link to open the file and click on the save button and selecting your desktop as the location.
- To Email all forms, just click here and include the documents as an attachment. Please add as subject line: Patient Forms.
We are looking forward to meeting you!
Please print and fill out these forms so we can expedite your first visit:
- New Patient Information Form
- Acknowledgement of Liability Assignment of Benefits
- Operating Policies & Procedures
- Consent to Disclosure Information
- Urine Drug Screening Affidavit
- Pain Diagram Form
- Medical Questionnaire Form
- Office Policies for LOP Patients
- Professional Service Lien
- Application for Florida "NO FAULT" Benefits
- Standard Disclosure & Acknowledgement Form
In order to view or print these forms you will need Adobe Acrobat Reader installed.
Click here to download it.
Map and Directions
What To Expect
Being well prepared for your appointment will ensure that your pain specialist has all of the needed information to provide the best possible care for you. It also will help relieve any unnecessary anxiety you may be feeling. Educate yourself on your symptoms by reviewing the content on this website. Also, take some time to review our staff page and familiarize yourself with our pain specialists. We look forward to your first visit.
We are provider for all Motor Vehicle Insurances and Florida Workers' Compensation.
We accept Letter of Protection (Case by case only) and Self Pay Patients.
We are currently participating with the following health insurances: