Patient Information

To Our New Patient,

Welcome to Balance in Life, P.C. Pain Management & Wellness Center.  Your first appointment is very important to us.  It involves a full-hour or more of information gathering, an examination and the clarification of your underlying conditions. We will also discuss treatment modalities felt to be appropriate in addressing the patient’s problems.

In order for us to gainfully use every essential moment of your appointment, we ask that you download and complete the three Patient Forms on this website: Patient Information Sheet, Patient Information & Medical History Form, and Patient Consent Form.  Either scan and email, or fax the completed forms back to our office prior to your initial appointment.  If more convenient, you may bring the completed forms with you to your initial appointment.

Please also bring with you a photo ID, your insurance card(s), and your Social Security Number.  This information is necessary for office billing purposes.  We are also required by law (Red Flag Law) to keep copies of these identification cards on file to protect you from Identity Theft.

We would also greatly appreciate it if you could please arrive at least 15 minutes prior to your scheduled appointment.  We will use this time to prepare and organize any last minute details.

Thank you very much for your cooperation and we look forward to seeing you!


Yvonne B. Srutwa
Balance in Life, P.C.
Pain Management & Wellness Center