SXM   SYMPTOM MEDICINE

Pain Medicine, Palliative Care, Anesthesia


2030 NORTH PACIFIC AVE., SUITE F, SANTA CRUZ, CA 95060

tel: 888.796.6331 fax 888.796.633

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FOR PROVIDERS
        Medical Services
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FOR PATIENTS

        Become a Patient

        New Patient

        Current Patient

        Forms & Contracts

ADMINISTRATION

         Clinic Policies & Terms

         Finances & Insurance

         Patient Information    

         Make a Payment

RESOURCES

        Education & Library

        Patient Support

        Concierge Services       

Patients will be required to read Clinic Policies and give an electronic signature to obtain any forms or reserve an appointment. This  website is not HIPPA secure; and thus, cannot accept or exchange ANY sensitive information or private data.

NEW PATIENTS

Once you have completed the steps Become a Patient, you can start the steps to become a New Patient.  Once everything is received and reviewed, an appointment will be scheduled.

  1.     SXM CLINIC PARTICIPATION

  2.     SxM CONTRACTED INSURANCE COMPANIES   

  3.     SxM PAIN FORM.   

  4.     SxM PATIENT FINANCIAL RESPONSIBILITY

  5.     SxM PATIENT SURVEY

  6.     SxM PAYMENT OPTIONS

  7.     SxM RELEASE OF INFORMATION

  8.     SxM TERMS & CONDITIONS OF SERVICE

  9.     Name and confirm the PCP who you will always coordinate and direct

       your care while a patient at SxM. 


For patients who are in need of a consultation, read, complete and sign the following.

  1.     SxM CONSULTATION REFERRAL FORM

  2.     SXM CONTROLLED SUBSTANCE EDUCATION

  3.     SXM OPIOID CONTRACT

  4.     SELF DETERMINATION FORMS


For procedure and anesthesia patients, read, complete and sign the following.

  1.     SxM CONSENT FOR PROCEDURE & ANESTHESIA

  2.     SxM ANTI-COAGULANT POLICY