Forms

Cancellations

Please note that the Helmcken Pain Clinic requires 24 hours (minimum) advance notice of cancellations. Late notice cancellations and missed new patient consultations will not be rebooked. You will require a new referral and may be placed back on the waiting list. Our waiting list is very long and short notice cancellations or missed appointments are unfair to other patients.

New Patients

Please complete a New Patient Questionnaire. The Helmcken Pain Clinic is a referral only specialist medical clinic. We only see patients who have been referred by another physician. *Some people have reported difficulty completing this form on smartphones. If this is the case please use a computer or android tablet*.

Ocean

New Patient Questionnaire

We use Ocean by CognisantMD to host our web forms. This is a Canadian company and all data is encrypted on their server. Your information can only be viewed with a decryption key that is held by the Helmcken Pain Clinic. Ocean servers are located in Canada.

If you do not feel comfortable or cannot complete the online form then you can download and complete the paper version or complete the form in our office. You MUST arrive 30 minutes early for your appointment to allow enough time to complete the form. Please note that the paper form does not give us as much information and can limit our ability to make a complete diagnosis.

Do you have headaches?

If you have headaches, we recommend you complete a headache diary using our form (below) or a free mobile app such as the Canadian Migraine Tracker or MigraineBuddy (Available on the Apple App and Google Play Stores). Insurers require accurate headache information before approving medications such as Botox and CGRP receptor antagonists. Missing information can lead to delayed or interrupted insurance coverage now or in the future.

An accurate medication history can also help us get insurance coverage faster. We can access 14 months of dispensed medication history from BC PharmaNet. Patients can download their complete prescription medication history dating back to 1995 from the following URL

Health Gateway

Health Gateway provides British Columbians with secure access to a single view of their health information, including prescription medication history.

If you are seeking treatment for migraine headaches, we request that you obtain your medication history and bring it with you to your appointment.

Referral form

Vist the following URL to view referral information and download the form:

HPC Referral Information & Form

Note: All referrals must include a completed referral form.