For Patients - About Your Visit
All patients here at Maryland Pain Specialists undergo comprehensive assessment including history and physical examination at their first visit. Part of the evaluation may involve a series of questionnaires or surveys designed to fully understand all aspects of the patient and their pain problem. These surveys include questions about physical and mental health to determine how the pain impacts physical functioning and quality of life. Our treatment plans are individualized to each patient by a highly-trained team of physicians, nurse practitioners, and physician assistants, who will be available to answer any questions you may have.
Your Rights and Protections Against Surprise Medical Bills Good Faith Estimate DisclaimerOffice Forms
ONLINE FORMS
- If you are scheduled at a MARYLAND PAIN SPECIALISTS OFFICE LOCATION (includes Main Office, Bel Air Office, Hunt Valley and The Spine Institute) for NEW PATIENT CONSULT (with or without a procedure) click the box below.
MPS NEW PATIENT ONLINE FORM - If you are scheduled at RUXTON SURGI-CENTER for NEW PATIENT CONSULT & PROCEDURE, click the box below.
RSC NEW PATIENT ONLINE FORM
- If you are scheduled at UNIVERSITY OF MARYLAND ST JOSEPH MEDICAL CENTER AMBULATORY SURGERY CENTER for NEW PATIENT CONSULT & PROCEDURE, click the box below.
UMSJMC NEW PATIENT ONLINE FORM
- If you are an ESTABLISHED PATIENT coming for a FOLLOW-UP VISIT (at any of our locations) CLICK the box below for the FOLLOW-UP QUESTIONNAIRE.
Follow Up Questionnaire
- Opioid Agreement Form
- Medical Records RELEASE
If you want to receive your records from Maryland Pain Specialists or send them to another provider, please complete this RELEASE FORM - Medical Records REQUEST
If you are requesting records from another provider to be sent to Maryland Pain Specialists, please complete this REQUEST FORM. Once received, we will fax to provider on your behalf. - Privacy Practices
- Patient Preferred Contact Information
- General Consent
- Formulary Benefits Data Consent
- Pt. Authorization/Portal-Telehealth Consent
- Financial Policy
- Consent Packet – Includes all consent forms
Consent Forms
ATTENTION ALL PATIENTS: If you completed one of our New Patient Online Forms, please DO NOT complete any consent forms below as they are already included in the NEW PATIENT ONLINE FORMS. Please DO NOT COMPLETE A CONSENT FORM unless a staff member has made a specific request for you to do so.
Referral Forms
If your insurance is an HMO that requires a referral form, it will be necessary for you to bring your referral with you on your first visit. If you do not have this referral, your appointment must be rescheduled until a referral is obtained. Before coming for your first visit, please check with your insurance carrier regarding your need for a referral.
Workers' Compensation
If your condition is the result of a work-related injury for which a workers' compensation claim has been filed, it will be necessary for us to obtain authorization from your workers' compensation carrier or to get a copy of your denial letter before your appointment can be scheduled.
FCEs and Disability Ratings
Our physicians do not perform functional capacity evaluations (FCEs) or give disability ratings. For these services, we refer patients back to their referring physician or to an outside source that performs this service.
Affiliated Hospitals
Affiliated Ambulatory Surgical Centers
- Ruxton Surgi-Center (RSC)
- UM St Joseph Medical Center Ambulatory Surgery Center
Pre Operative Instructions
These instructions apply to most procedures. For your specific instructions please contact the office. (410-825-6945)
Office hours
Monday through Friday, 8:00 AM to 4:00 PM
Insurance
Most insurances accepted.
Payment Options
Credit cards, Cash, check or money order.
Please use your ACCOUNT # from your statement as the PATIENT ID
Emergencies
Please call 911 or go to your nearest emergency room.
Medical Images
If you have had medical images taken recently, please bring them with you on your first visit. These images include X-rays, MRIs, CT-myelograms, bone scans, or EMG-NCV reports.