Second Opinion Program

Getting a second opinion before undergoing surgery is a smart and proactive step. It can help ensure that you are making an informed decision about your health and that the proposed treatment plan is the best option for you. Our Second Opinion Program may help give you greater confidence in your treatment plan and help you make a more informed decision about your health.

Here to assist you

Get a Second Opinion

Let us know a brief history of your case and we will contact you with an assessment.

Full Name

Phone

What Are Your Main Concerns?

Onset of Symptoms

Change in Symptoms

Average Pain (1-10)

Laying Tolerance

Standing Tolerance

Ambulation Tolerance

Previous/Recent Imaging Studies:

Previous DEXA:

XR CS

Yes No

AP/Lat/Flex/Ex

Yes No

MRI CS

Yes No

CT CS

Yes No

XR Scoliosis

Yes No

XR TS

Yes No

MRI TS

Yes No

CT TS

Yes No

XR LS

Yes No

AP/Lat/Flex/Ex

Yes No

MRI LS

Yes No

CT LS

Yes No

CT Myelogram

Yes No

CT TS

Yes No

MRI

Yes No

Previous Treatments:

Previous Providers

ESI

Yes No

SI Joint Injections

Yes No

Physical Therapy

Yes No

NSAIDs

Neuroleptics

Gabapentin Lyrica N/A

Current Tobacco Use

Yes No

Muscle Relaxants

Yes No

If Yes, State Relaxants

Pain Medications

Yes No

Previous Surgery

Yes No

Other:

Verbal consent from patient to obtain medical records from previous providers and imaging centers?

Yes No

Here to assist you

Quick Contact

SWAN Brain and Spine is contracted with HonorHealth facilities, and works in collaboration with Next Era Spine Care at our office in Paradise Valley, AZ.

Second Opinion Program

Here to assist you

Get a Second Opinion

Previous/Recent Imaging Studies:

Previous Treatments:

Here to assist you

Quick Contact

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