All NEW patients must have the following:
- Referral from a primary care provider or from a physician currently treating your pain (this must be on the physician's letterhead or on a prescription pad)
- MRI or CT (taken within the last 5 years) - Please note that we will refer you to have imaging if you do not have anything recent and you will be required to have this done within three months to continue treatment.
- For conditions where imaging may not be applicable, such as rheumatoid arthritis, cancer, shingles, etc., we require medical records (and/or surgery notes, lab tests, etc.) from the referring physician documenting the medical condition requiring pain management. If you have any questions regarding this, please call us.
- Printout of at least 1 year of Pharmacy Records (you can request this from your pharmacy)
- State Issued ID
- 2 proofs of residency (Address must match what is on the ID)
- Any prescriptions filled in the last 28 days – in the original bottle. Please note that your appointment will be scheduled a minimum of 28 days after your last prescription for pain medication was filled.
- Payment can only be made via a Debit or Credit Card, and the card must have patient’s name on it (per state law)
- You will be required to take a urine drug screen every visit. You cannot be seen if you have a medication in your system for which you do not have a prescription OR that prescription was filled more than 90 days ago.
- You cannot and will not be seen if you have illegal drugs in your system. If you use methamphetamines, cocaine, Ecstasy, etc., just don't schedule an appointment with us - we will not see you as a patient.
- At the present time, we only see patients who are residents of Tennessee or Georgia.
New Patient Paperwork
To save time at your initial appointment, you may print the forms listed below and fill them out at home – but please remember to bring them with you! If you do not have a printer, you may complete the paperwork in our office, just be sure to arrive 30 minutes prior to your appointment time.
- Referral Sheet – Must be completed by your referring physician
- New Patient Paperwork
- Medication Agreement and Urine Drug Screen Policy
- Pharmacy agreement
- HIPPA form
- New Patient Checklist
Wellness First provides quality, compassionate pain management to all patients, including those without insurance. For questions regarding insurance, please call us at 423.825.4800.