Attending Physician Advisory Form

As part of an on-going project on "Coping With Crisis", the resident research analyst at "Living With TN" has developed a form that may help you to prepare in advance for times when you need emergency assistance.  The idea is to fill out the form and keep it with you wherever you go.  It is designed to tell an emergency room admissions clerk that you need immediate intervention care for intense pain, and to provide an attending doctor information they will need to treat you.

The form is now available through my personal website at

http://www.lawhern.org/AttendingPhysicianAdvisory.doc

Feel free to download, fill it out, and carry it with you.  You are also welcome to share it with other patients or with your doctors for their use, so long as the copyright announcement is preserved on the bottom of the printed form.  That announcement is intended to bring more people into our community.

In late November 2011, Phoebe, one of our members at Living With TN made use of this form in getting assistance at a hospital Emergency Room.  The following is a summary of her experience:

          "Earlier in the day I had prepared [the Attending Physician Advisory form], a medical history form I found on the web, and the picture I drew of the pain.  When we got to the hospital I had my husband drop me off so he could park the car, I didn't want to waste any time, and I went in an pretty much about threw the papers at the registration people... I don't know anyone else has done with these papers but they sure did the trick for me.  I didn't have to wait to be seen at all.  This time, instead of a PA only I had nurses, doctor, techs, etc.  They put a port in my arm.  It took 3 doses over a few hours but I finally did not feel my mouth.  They also gave me IV doses of Prednisone and something for nausea..."

For other information on diagnosis and treatment of facial pain, we encourage you to read the "Face Pain Info" tab in the top menu for all pages on this site. 

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Go in Peace and Power

  R. A. "Red" Lawhern, Ph.D., page lead

  Stef and Gloria E, page moderators