Interventional Pain Medicine P. Tennent Slack, M.D. Dr .
Interventional Pain MedicineP. Tennent Slack, M.D. Dr. Greg Jackson, M.D.GainesvilleMedical Park 1, Suite 3001315 Jesse Jewell ParkwayGainesville, GA 30501770-219-6520 Phone770-219-1078 Fax Ben Fleming, PA-CBraseltonMedical Plaza B, Suite 4021404 River PlaceBraselton, GA 30517770-219-6520 Phone770-219-1078 FaxDear Valued Patient,We are so grateful you have entrusted us for your healthcare needs. We look forward to serving you.Based upon the information obtained from your referring physician, as well as Dr. Slack’s assessmentof you, a treatment plan will be formulated. Example treatment plans consist of site specific injectionstargeting the underlying cause of pain.Please note: Opioid therapy (common Opioids include: Lortab, Percocet, Fentanyl, etc.) may orMAY NOT be used. Please do not expect to receive a prescription for an opioid medication at yourvisit. If you would like to discuss the above treatment approach prior to your visit, please contact ouroffice.Please arrive 20 minutes prior to your scheduled appointment. Please bring your Photo ID andInsurance Card(s) along with any imaging discs. Please complete the following paperwork prior toyour appointment with Interventional Pain Medicine and bring it with you to your appointment.If you wish to change your appointment date or time, please call our office at 770-219-6520.Best Regards,The Scheduling Departmentneurosciences.scheduling@nghs.com
Northeast Georgia Physicians Group- Interventional Pain MedicineDATE: NAME: AGE:Weight: Height: BP: / Pulse: Resp: O2: Temp:What problem are we seeing you for?Have you had CT, MRI, X-Rays or EMG Study done?YesNoIf so, where and when:PAST MEDICAL HISTORY: Have you ever been diagnosed with any of these conditions?Migraine HeadachesLow Blood PressureStomach UlcersProstate EnlargementImplanted DevicesHigh CholesterolDiabetesEpilepsyStrokeThyroid DiseaseLow Blood SugarArthritisCarotid Artery DiseaseAsthmaLiver DiseaseFibromyalgiaCoronary Artery DiseaseEmphysemaHepatitisPsychiatric DisorderHeart AttackCOPDKidney StonesAnxietyAbnormal Heart RhythmCongestive Heart FailureKidney DiseaseClaustrophobiaTuberculosisAnemiaHigh Blood PressureHave you ever had cancer?YesNo Where?PAST SURGICAL HISTORY: Have you ever had any of the following surgeries?Back SurgeryCardiac StentWhen:Neck SurgeryJoint Replacement Which Joint(s)?Carotid SurgeryOther Joint Related SurgeriesBrain SurgeryCarpal Tunnel RepairPacemakerSpinal Cord Stimulator TrialSOCIAL HISTORY:Alcohol Use:YesTobacco Products:No How Often?YesNo Packs per day?Are you currently working?YesDisability?PendingYesNoNo Occupation?History of Substance Abuse:YesNoAre you Pending gFAMILY HISTORY: Do any of your blood relatives have or have they ever had any of these conditions?Heart DiseaseKidney DiseasePsychiatric HistoryHypertensionNeurological Illness / DisorderDrug AbuseStrokeSeizure DisorderParkinson’s DiseaseBack SurgeryDiabetesArthritisMigrainesBrain AneurysmTremblingFamily Member(s) currently on narcotics?Family History of Cancer?YesYesNoNo If Yes, What type(s)?REVIEW OF SYSTEMS (Check Current or Present Symptoms):GENERAL:Weight LossWeight GainFeverChillsFatigueWeakness
SKIN:RashesLesionsLumpsSlow Healing WoundsDouble VisionBlurry VisionLoss of VisionRinging in EarsVertigoNose BleedWheezingShortness of BreathPainful BreathingSwellingShortness of Breath with ActivityTightnessVomitingConstipationDiarrheaLeg SwellingCalf Pain when WalkingMuscle ory LossDifficulty ssionEYES:PainEARS, NOSE & THROAT:Hearing LossSore ThroatRESPIRATORY:CoughCARDIOVASCULAR:Chest Pain or DiscomfortGASTROINTESTINAL:NauseaVASCULAR:Leg CrampingMUSCULOSKELETAL:Muscle or Joint PainNEUROLOGIC:DizzinessPSYCHIATRICLoss of ConcentrationHEMATOLOGIC:Ease of BleedingURINARY:Ease of BruisingFrequencyPainful UrinationAll other systems reviewed and negativeAllergies?YesNo If yes, please list allergies and reactions:Please note: As NGPG Interventional Pain Medicine utilizes alternative treatment options for pain, opioidmedications (example: Lortab, Percocet, Fentanyl, etc.) will not be prescribed unless deemed clinicallyappropriate by your provider. Your signature below represents your acknowledgement of this policy.Patient SignatureDate:
Northeast Georgia Physicians Group- Interventional Pain MedicinePain Survey*Please Thoroughly Complete Both Sides of This Survey*Name: Date:Location: In what part of your body is your pain the worst?Radiation/Referral Pattern: Does your pain travel to other locations? (Please be as specific as possible.)Quality: How would you describe your pain (aching, burning, etc.)?Severity: Rate your pain on a scale of 1-10:Duration: For how long have you experienced your current pain?Is the pain constant?Timing: At what time of day (or night) is the pain at its worst?Aggravating Factors: What activities worsen the pain?Alleviating Factors: What makes the pain better?Functionality: Are you exercising, walking, stretching, etc?Work: Are you working full-time? Part-time?Sleep: How many hours of sleep do you get per night? Would you consider this quality sleep?Mood: How is your mood (irritable, sad, happy most of the time, etc.)?
Pain DiagramName: Date:Please mark the area of injury or discomfort on the chart below, using theappropriate symbols:NumbnessPins & NeedlesBurningAching---------OOOOO xxxxx---------OOOOO xxxxxStabbingPlease make a slash through the line below to indicate your current pain level.No Pain Worst Possible PainPatient Signature: Date:
*MEDICATION LIST*NAME: DOB:PHARMACY: PHONE:PLEASE PROVIDE US WITH COMPLETE LIST OF MEDICATIONS BELOW, INCLUDING DOSEAND HOW MANY TIMES PER DAY YOU TAKE EACH MEDICATION.MEDICATIONDOSETIMES PER DAY
Interventional Pain Medicine P. Tennent Slack, M.D. Dr. Greg Jackson, M.D. Ben Fleming, PA-C Gaines
24% to 30% and crucially, Hall & Partners analysis shows a rise of 7% in the 18-24 group when asked whether Tennent’s Lager is their favourite brand. These statistics have also risen amongst Tennent’s consumers generally by 2%. At the end of 2015, Tennent’s increased volume by 2.7% and value by almost 0.5% in the off-trade.
COMPREHENSIVE REVIEW COURSE PAIN MEDICINE AND INTERVENTIONAL PAIN MANAGEMENT 51 AMA PRA Category 1 Credits A VIRTUAL MEETING NOVEMBER 6-8 AND 13-15, 2020 This course, promoted in collaboration with PainExam.com and PainCast , offers preparation for ABMS Pain Medicine Board Examination, Controlled Substance Management Competency,
pain”, “more pain” and “the most pain possible”. Slightly older children can also say how much they are hurting by rating their pain on a 0-10 (or 0-100) scale. Zero is no pain and 10 (or 100) is the worst possible pain. What a child is doing Often children show their pain by crying, making a “pain” face, or by holding or rubbing .
INTERVENTIONAL RADIOLOGY: MAPS 99–102 253 Context Interventional radiology (IR) refers to a range of techniques that use radiological image guidance to target therapy, and interventional radiologists are trained in both radiology and interventional therap
Short-term pain, such as when you suffer a sprained ankle, is called 'acute' pain. Long-term pain, such as back pain that persists for months or years, is called 'chronic' pain. Pain that comes and goes, like a headache, is called 'recurrent' pain. It is not unusual to have more than one sort of pain or to have pain in several places
General discussions of pain often refer simply to three types: 1) Acute (brief that subsides as healing takes place) 2) Cancer 3) Chronic non-malignant pain - "persistent pain" Classification of pain by inferred pathology: 1) Nociceptive Pain 2) Neuropathic Pain (McCaffery & Pasero, 1999) Nociceptive Pain A. Somatic Pain B. Visceral Pain
Knee Pain 1 Knee Pain 2 Knee Pain 3 Knee Pain 4 Knee Pain 5 Lateral Knee Pain Medial Knee Pain Patella Pain 1 Patella Pain 2 Shin Splint. 7 Section 6 Ankle/Foot Big Toe 89 . For additional support, wrap another tape around the last finger joint. Step 3. No stretch is applied during application. 30 Step 1 Step 2 Finger Pain. 31 Requires;
Advanced level Speciflcation summary 1. 2 Advanced level Speciflcation summary Qualification objective CIPD Advanced level qualifications provide a depth of knowledge alongside the opportunity to specialise in chosen areas of expertise. Candidates will be able to develop their understanding of organisations and the external context within which HR operates. Using critical analysis, self .
