Arroyo Vista Advanced Pain Specialists, Inc.

Telephone # (805) 222-4549                Facsimile # (805) 529-4549              

Patient Forms and Portal

Patient Forms:

New Patients:

Prior to your first appointment, please click on the first Click Here" button below which will open another window with our New Patient Package.  Please print and complete each of the forms in the package. Please note that pursuant to Federal law, these forms cannot currently be completed, saved or returned to us online, as original (non-electronic) signtaures are required.   A complete medical history is essential to providing you with appropriate care.  If you have any questions about the information that is requested, or require any help completing these forms, please speak with the doctor during your appointment.


Please also remember to ask each of your medical providers for copies of your medical records.  They are required to provide you with copies of the notes from each office visit as well as a comprehensive electronic record of your treatment at your request.  Please bring those records with you, as well as any X-Rays, MRI's, CT's, and any other studies as well as the reports from the radiologists or other specialists who reviewed them.

Existing Patients:

Immediately prior to each follow-up appointment, please download, print, and complete the following form and bring it with you to the appointment. Please note that this form cannot be completed, saved or returned to us online. 



Patient Portal:

After your first appointment you will be invited to register for our Patient Portal and we will provide you with a PIN which you will need to Register. Please click the blue "Click Here" button below to access our Patient Portal, powered by AthenaHealth(c) our electronic medical records service provider.  Once you have registered, you will be able to accomplish a wide range of goals using this portal. In addition to securely communicating with the practice, you will be table o request appointments, review and make payments on your account, research health issues, and much more. Please note that New Patient registration, medical history, and other forms may not be completed on the Patient Portal (please see "New Patients" above). 


In a medical emergecny please do not use the Patient Portal to communicate with the practice. Instead, please call 911.