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ACADIA COGNITIVE BEHAVIORAL PAIN PROGRAM PATIENT REFERRAL FORM Physician Referrals: 9736100 or Fax Referral Form To: 9736109 Attn. Brent Score Upon receipt of this form the patient will be contacted
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How to fill out Acadia Cognitive Behavioral Pain:

01
Start by providing your personal information, including your full name, contact information, and any relevant identification numbers.
02
Next, carefully review the instructions and guidelines provided by Acadia Cognitive Behavioral Pain. Make sure you understand the purpose of the form and the information it requires.
03
Begin filling out the form by answering the questions or providing the requested information. Be thorough and accurate when providing details about your pain and any related symptoms. Use clear and concise language to communicate your experiences.
04
If applicable, provide information about your medical history, including any previous treatments or medications you have tried for your pain. This background information can help healthcare professionals better understand your situation and tailor their recommendations accordingly.
05
Consider including any additional information that you believe is important for assessing your pain. This could include any specific triggers, physical limitations, or emotional factors that contribute to your pain experience.
06
Before submitting the form, review your answers to ensure they are complete and accurate. Double-check for any spelling mistakes or inconsistencies.

Who needs Acadia Cognitive Behavioral Pain:

01
Individuals experiencing chronic pain: Acadia Cognitive Behavioral Pain is specifically designed to address the needs of individuals living with chronic pain. It offers an evidence-based approach to managing and understanding pain, with a focus on cognitive-behavioral techniques.
02
Patients seeking non-pharmacological pain management strategies: For those who prefer non-pharmacological interventions or have not found relief from medication alone, Acadia Cognitive Behavioral Pain can provide valuable tools and resources to manage pain effectively.
03
Healthcare professionals: Acadia Cognitive Behavioral Pain may be utilized by healthcare professionals, such as doctors, nurses, psychologists, or therapists, who specialize in pain management and wish to incorporate cognitive-behavioral strategies into their treatment plans.
Remember, always consult with a qualified healthcare professional for personalized advice and guidance related to your specific pain condition.
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Acadia Cognitive Behavioral Pain is a specialized treatment approach that combines cognitive therapy with behavioral therapy to help individuals manage and cope with chronic pain.
Patients experiencing chronic pain and seeking alternative treatment options may be required to file for Acadia Cognitive Behavioral Pain therapy.
To fill out Acadia Cognitive Behavioral Pain therapy, individuals should consult with a licensed therapist specializing in cognitive behavioral therapy for pain management.
The purpose of Acadia Cognitive Behavioral Pain therapy is to help individuals develop skills and strategies to better manage their chronic pain, improve their quality of life, and reduce reliance on medication.
Information such as the patient's medical history, current pain symptoms, treatment goals, and progress in therapy must be reported on Acadia Cognitive Behavioral Pain forms.
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