We are honored that you are considering care with Jaffee Ethical Addiction & Pain Care. Please review the following steps and requirements to ensure a smooth first visit:

1: Referral (Optional)
A referral from your doctor is appreciated but not required to become a patient.

2: Insurance & Payment

• We’re currently in the process of rejoining insurance networks.

• If we’re not yet in your network:

  • We can still see you if you have out-of-network benefits.

  • We’ll work with you to minimize costs and may arrange a reasonable payment plan if needed.

• Co-pays and balances are due at the time of your visit.

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3: Medical Records
If you’ve had any X-rays or MRI scans, please have your provider send those to us before scheduling your appointment.

4: Patient Forms

1. Choose the packet that applies to you below.

2. Download and complete the forms.

3. Bring them to your first visit.

 
All forms are linked below — you only need to complete the ones that apply to your situation.

5: Scheduling
Email us at info@jaffepainclinic.com to request an appointment.
Once we receive your forms and medical records, we’ll confirm your appointment date and time.