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Full Name

Type of Document

Document Number

Type of User

Contact Number

Your e-mail address

Reason for consultation

Additional Information (optional)

NOTE: Please ensure that you upload any previous medical exams, such as X-rays, MRIs, or other relevant imaging, as well as any test results or documents necessary for your consultation with the pain specialist at CEAD. Additionally, if you are covered by an insurance policy, kindly attach a copy of your insurance details.

* By filling out the fields with your information, and clicking on the “Submit” box, you are accepting the personal data protection policy provided by Alivium SAS, which can be found at the following link.

You can also book your appointment by writing to our WhatsApp by clicking on the button below.

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What should I bring to my first appointment with a pain specialist?

ID

Identity document, order and authorization of the health entity to which you belong (if applicable).

Previous medical history

Medical Examinations

Tests related to your painful condition (labs, x-rays, CT scans, MRIs, EMGs and others as appropriate).

Medications

List of medications you are currently taking for any pathology.