Dr. Sajben specializes in complex intractable cancer pain and chronic pain. The office is located on the campus of Scripps Memorial Hospital in La Jolla.
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New patients, please bring the following to your appointment:
- bottles of all your medications, bottles of vitamins and supplements so that I can read the labels
- medical insurance card
- completed forms#1 through #6
- check or cash for payment
- You are encouraged to bring your medical questions and concerns to discuss them with me. Family members and friends are always welcomed.
1. Instructions for First Visit (pdf)
2. Release of Medical Records (pdf) Do this first. Fax or mail your doctors directly. Allow doctors time to get the records to me or that may delay treatment. Bring a copy of the release forms to your visit – we may need it.
3. Demographics (pdf)
4. Medications (pdf) this form is important. It is not necessary to duplicate this information on the next form.
5. Medical History (pdf)
6. Brief Pain Inventory – First Visit (pdf) - This form for is only for those who have pain.
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Please do not fax these forms to me. I need the originals.
We validate $1.00 off the $4.00 parking fee. The stamp is on the front counter. There is no fee if you have a disabled parking sign.
Payment is requested at the time of visit. I do not accept credit cards. I do accept Medicare and as a courtesy, will electronically bill for services.
Before you call, you may wish to call your insurer and ask what they reimburse for an “out of network” doctor for these billing codes:
99205 – initial patient evaluation (1 hour)
99215 – return visit (40 min)
Keep in mind if you have a complex condition, your visit may last longer and time will be billed accordingly or may need to be rescheduled for several reasons: complexity, contributing medical and/or psychiatric conditions, failure to obtain medical records, substance abuse issues, after hours, reports.
I am generally available to my patients Pacific Standard Time afternoons, evenings, weekends, holidays—not mornings. I am not in the office on Tuesdays.
I look forward to seeing you and helping you and your family on this journey to improve pain and function.
Warm regards,
Nancy L. Sajben MD
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Return visits
Pain Care Progress Note (doc) 103 KB —- use font Ariel 10 point to fit on one page. You can save this form on your computer, fill in your medications on the form you just saved, print and reuse it – but keep it updated on medication changes. That will save you from having to rewrite them each visit.
Pain Care Progress Note (pdf) 108 KB — This version of the above form will fit on one page. You are unable to list medications on this page with computer. Instead, complete form and fill in medications with pen.
Log (pdf)
Neuropathy Pain Scale (pdf)
Dry Mouth & Thick Saliva, Saliva Substitutes(pdf)
Constipation (pdf)
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Return to home page: Welcome to my Weblog on Pain Management!
