PRINTABLE DOCUMENTS

2 WEEK PAIN DIARY

6 HOUR PAIN DIARY

PRP Jnts/Tnds/Ligmts  INTAKE FORM

REGULAR CONSULTATION QUESTIONNAIRE

PRP PRE TREATMENT INSTRUCTIONS

PRP POST TREATMENT INTRUCTIONS

MEDICATIONS TO AVOID FOR PRP

FACET INJECTIONS

MEDIAL BRANCH BLOCKS

RADIOFREQUENCY NEUROTOMY

DUROLANE FAQ

EXERCISES

 

If you are interested in Platelet Rich Plasma(PRP) and would like to receive an assessment for your tendon/joint/ligament, please fill out the intake form below and have your doctor send a referral to our clinic. Please make sure you have also had some type of imaging(MRI, X-ray, Ultrasound etc) within the last 2 years.

*Please note this form is only to be filled out if you are interested having joints/tendons/ligaments sites treated. If you are interested in having your back or neck assessed you will need to complete the Regular Consultation Questionnaire

*We are only treating patients who reside in Canada. Before taking the time to fill out the questionnaire below, please know that the regenerative procedures performed at the clinic are not covered by provincial health care plans and will need to be paid for by the patient.

© 2016 CAPRI Central Alberta Pain & Rehabilitation Institute