Patient Forms

Click on a link below to download:


New Patient Intake Form


Patient Initial Evaluation History & Physical Form


PCA Narcotics Agreement

Notice of Privacy Practices

Discrimination Policy


Note: To view or print these forms, you will need Adobe Acrobat Reader. Click here to download it.


Words from our patients

  • ZocDoc

    "The doctor explains all of your options, makes sure you understand everything he has explained, answers all of your questions and does not rush you out of the office."

    Maney M.
  • Healthgrades

    "He seems to be very compassionate listening to my fears and willing to work with me. Explained my problem well, as well as, procedure."

  • Vitals

    "I have finally found a doctor who has been able to control my pain. Dr. Adlaka has given me my life back!"

    Verified Source
  • Vitals

    "I suggest you see him for any type of pain you are suffering from. I have sent several family members to see him for his back pain treatment!"

    Verified Source

Get Back In Control! Give Us A Call Today.

Now Accepting New Patients & Same Day Appointments!

We Use Innovative Technology And The Latest Treatment Interventions In Pain Management.

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