Physician Pain Care | Woodstock | Jasper | Acworth

Medication Agreement Form

If you prefer to print your form, click here. Please complete the form and either fax it to (770) 516-7870 in advance of your appointment or bring it with you to your appointment.

If you prefer to fill out your form online, please complete and submit the form below.


Providing Quality Care

Dr. Jeffrey Rubin and the staff of Physician Pain Care provide quality, cutting edge, personalized service to patients suffering from chronic pain. We offer Epidural and Facet Joint Injections, Spinal Cord Stimulation, Lumbar and Medial Branch Blocks, Radiofrequency Ablation, SI Joint Injections, Stellate Ganglion Blocks, Transforaminal Epidural Injections, and BOTOX injections for migraine headaches.

We treat patients in Woodstock, Canton and Marietta, Georgia. Many patients visit us from Jasper, Ellijay, Cumming, and Roswell, GA. Please call (770) 516-7880 to schedule an appointment or request additional information on any of our services or procedures.

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