Thank you for selecting Dr. Nosheen Hasan at the Center for Pain Management for your pain management treatment. For questions, please call us at (414) 444-8670 ext. 8. In addition to your written referral, we need the last two visit office notes, pertaining the chronic pain issue, and imaging results, in written form please.
Once you have made your initial appointment, you may pre-register by downloading, printing, and completing the forms below. Please be sure to bring them with you to your first visit. Completing the forms prior to your visit will help speed up the new patient registration process.
Downloadable Forms:
*If you are requesting medical records, it may take up to 3 weeks to receive your entire record. However, we can give you the last 2 notes on the day of your request. Please call our office to discuss our administrative fees.
Please note: It may take a few minutes to load the forms if you are using a dial-up internet connection. If you are unable to view the forms, you may need to download Adobe Acrobat for free by clicking on the icon below.
REQUEST FOR AN APPOINTMENT
