Massachusetts General Hospital Department of Anesthesia, Critical Care and Pain Medicine - Clinical Services > MGH Pain Management
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Surgical Anesthesia

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Center for Pain Medicine

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Questionnaire for New Patients

Welcome to The Center for Pain Medicine at Massachusetts General Hospital. We ask that you help us by providing as much information as you can regarding your current condition and ongoing treatment, as well as any prior diagnostic tests and treatments you may have had. This questionnaire is designed to step you through all areas of your past and present medical care. Please complete as much of the questionnaire as you are able prior to your first visit, so that we can use this information at the time of your first visit to get a complete picture of you and your overall condition. Please do not hesitate to ask any of our staff or physicians for assistance if you have any questions or concerns. We look forward to meeting you. 

Questionnaire for New Patients (PDF)


Office Information

Center for Pain Medicine
Wang Ambulatory Care Center, Suite 340
15 Parkman Street
Boston, MA 02114
Phone: 617-726-8810
Fax: 617-726-3441

Public Transportation Access: Yes
Disabled Access: Yes

Mass General West
Center for Pain Medicine
Specialty Suite, Third Floor
40 Second Avenue
Waltham, MA 02451
Phone: 617-726-8810
Fax: 617-726-3441