SERVING SAN JOSE / SAN FRANCISCO BAY AREA 408- 364-1616 spinal stenosis sciatica back neck disc radiculopathy lower back pain exercises PAY YOUR BILLS SECURELY ONLINE HERE PATIENT RESOURCES : BACK, NECK, AND DISC RADICULOPATHY PLEASE PRINT FORMS BELOW OUT AND HAVE IT FILLED OUT PRIOR TO YOUR APPOINTMENT. This will expidite and improve your care. NEW PATIENT FORMS Please download these patient's intake form for your first visit with us. SSMG Patient Registration & Pain Diagram & Health Questionnaire (pdf) Download Dr Murakami -- Health Questionnaire Intake (pdf) Download Patient Rights & Reponsibilities (pdf) Download MEDICAL RECORD RELEASE AUTHORIZATION Please sign this form so we can obtain medical record from your other treating/referring physicians. Files coming soon. PATIENT EDUCATIONAL MATERIAL Information regarding your upcoming procedures. Epidural Injections Information Instructions (pdf) Download Facet Injections Information Instructions (pdf) Download Lumbar Exercise Sheets for patients (pdf) Download Pre & Post Procedure Guidelines & Procedure Consent (pdf) Download EMG-NCS Information Instructions (pdf) Download PROTECTED HEALTH INFORMATION (HPI) AUTHORIZATION Please sign this form to allow us to disclose your information and communicate with you electronically. Files coming soon. Copyright © 2020 ss - All Rights Reserved. designed by iFindDoc Back PainLow Back PainMechanical Back PainHerniated DiscJoint PainKnee PainAblation ArthritisNeck PainRadiculopathyRegenerative MedicineSciaticaShoulder PainSpinal Cord StimulationSpinal StenosisSports MedicinePRP TherapyStem Cell TherapyPAY BILLS / FORMSCONTACT USFAQ