Initium CPM referral
Initium Centre for Pain Medicine referral eForm. Created at the request of the Chilliwack Division of Family Medicine.
Open Source Clinical Applications and Resources
Open Source Clinical Applications and Resources
Community Pain Management Program Fraser Health
for referral to Fraser Health’s Community Pain Management Program. Has links to the Fraser Health Version of the Brief Pain Index and the Primary Care Provider Patient Summary.
BPI Short Form Fraser Health Pain Clinic
Updated 2020-Oct-13 06:36 drawing code hived off, calculations updated, previous values pulled. Please not in order to pull previous values add measurements must be made. Based on the form by Charles S. Cleeland PhD and the Pain Research Group. The…
VIHA Outpatient Pain Management Referral 2020
Created by Dr. Ian Bekker. Referral form for the Outpatient Pain Management Clinics run by Vancouver Island Health Authority. I have made some modifications: radio X-boxes, increase or decrease font size in textarea, added placeholders, added links to other parts…
Pain Disability Index ( PDI ) V2 2019
Updated by Gunther Klein to improve printing output. Pure HTML file to be uploaded (not imported). Saved as a .html.txt file so that it would upload to this site. Once you have downloaded it, remove the .txt from the end…
Tampa Scale for Kinesiophobia
2019-Aug-21 08:07 Created by Gunther Klein
Burnaby Hospital Pain Clinic Referral eForm 2019
Referral to Dr. Gavin Gracias at the Burnaby Hospital Pain Clinic