• Patient Summary

    In order to schedule an appointment with Dr. Williams, he requests that each patient complete this form. Please answer the questions below and provide a detailed patient summary of your condition from the very start of the problem up to the present time. The summary should be as detailed as possible yet limited to just the information that is relevant to the specific problem you are coming to Dr. Williams for. The summary should be written down in chronological order as you have experienced them. Avoid dramatic or emotional embellishment of your story. Above all, be sure to give a detailed, accurate description of where in your body your pain and other symptoms are located throughout your story. Peripheral nerves go to specific places. If you are inaccurate with your descriptions of where your pain is located, it could result in the wrong nerve(s) being identified which delays correct diagnosis and treatment.
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  • Please use the tools below to draw on the photos. Please mark specifically where the pain is. If the pain travels, please place an "X" where it starts with an arrow in the direction that it travels.


  • ***For all questions below, please be specific and detailed in your responses***


  • ***PLEASE NOTE: If you have the records in your possession, they can be attached below, or please have them faxed to 410-337-5520. We will need these PRIOR to Dr. Williams reviewing your form.***

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