Author: Robert M. Stein

Animal Pain Management Center
Located at
Amherst Small Animal Hospital

2217 Kensington Avenue
Snyder, NY 14226

Phone: 716-839-1100
E-mail: drstein@vasg.org
www.managingpetpain.com

Welcome to the Animal Pain Management Center

The APMC is a veterinary practice devoted to the alleviation of animal pain with the goals of increasing your pet’s quality of life and longevity. We offer many different management options including advanced oral pain medications, advanced intravenous and epidural (spinal) medications, physical rehabilitation, as well as TCVM acupuncture and herbal therapies.
Please indicate your interest in the following treatment categories - please circle the number that best represents your interest
Advanced outpatient pain medications Not very 1 2 3 4 5 Very interested Need more information
Advanced in-hospital pain therapies Not very 1 2 3 4 5 Very interested Need more information
Acupuncture Not very 1 2 3 4 5 Very interested Need more information
Herbal therapy Not very 1 2 3 4 5 Very interested Need more information
Physical Rehabilitation therapy Not very 1 2 3 4 5 Very interested Need more information
Please list the top goals you have for your pet. Be as specific as possible.
1. _____________________________________________________________________________
2. _____________________________________________________________________________
3. _____________________________________________________________________________
4. _____________________________________________________________________________
5. _____________________________________________________________________________
Many people consider their pets very important family members; some even consider their pet to be their most important life companion. Please circle the number that best represents your feelings about this description:
Disagree 1 2 3 4 5 Strongly agree
(Over)

Integrating Western Medications, Acupuncture, Physiotherapy and Advanced Anesthesia to improve the quality and extend the lives of our pets

Animal Pain Management Center
Located at
Amherst Small Animal Hospital

2217 Kensington Avenue
Snyder, NY 14226

For Referral Patients
I was referred by my regular veterinarian, Dr. _________________________________________________
The APMC prefers to operate on a referral basis whenever possible. This allows us to work with your regular veterinarians to achieve the best possible total care for your loved one. Your regular veterinarian, due to their familiarity with your pet, should be best positioned to provide care unrelated to your current concerns.
We will provide the diagnostic and therapeutic options best suited to manage your pet’s current problem only. Please contact your regular veterinarian for healthcare unrelated to your pet’s current concerns.
I agree to comply with the above policy
Name ______________________________________________________ Date ________________________
Nonreferred Patients
A friend or coworker suggested I contact you; _________________________________________________
I was not referred by anyone. This is a self-referral.
If so, how did you learn of our practice? _____________________________________________________
_____________________________________________________________________________________
If you were not referred by your regular veterinarian, did your regular veterinarian decline to refer your pet for treatment? Yes - No
If so, please explain ____________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________

Phone: 716-839-1100
E-mail: drstein@vasg.org
www.managingpetpain.com

Integrating Western Medications, Acupuncture, Physiotherapy and Advanced Anesthesia to improve the quality and extend the lives of our pets