Patient Information

Your First Visit?

iStock_000019237789Small

The Odyssey Pain Center is dedicated to doing all we can to ensure that you are on a path towards safe and effective pain relief. Your pain specialist at Odyssey Pain Center will be happy to work with you and your referring physician(s) to develop an individualized pain management treatment plan.

In order to make your appointment as successful as possible, please read the following so you arrive prepared and know what to expect.

Please bring the following to your appointment:

iStock_000014445371Small

Please bring the following required items to your appointment:

  • Your California Driver’s License or other government issued ID
  • Your Insurance card(s) and your co-pay(if applicable)
  • A list of current medications you take including prescription medicines, non-prescription medicines, the dose and how often you take each.
  • Any x-rays, CT scans or MRI reports you might have related to the problem for your pain specialist to review.
  • The contact information of your primary care physician and/or referring physician.
  • Your Completed and Signed Patient Forms(see below)

New Patient Forms

New Patient Questionnaire

Patient Registration form

Patient Financial Responsibility Policy

Record Release Authorization

Consent for use of Protected Health Information

Notification of Privacy Policy(HIPAA)

 

Insurance:

We accept the following insurance plans

Medicare
Aetna PPO
Blue Cross PPO
Blue Shield PPO
Cigna PPO
Healthnet PPO
UnitedHealthcare PPO

All other PPOs with out of network benefits.

We do not accept any HMO insurances

Please feel free to call our office at 949-207-7650 for more information