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forms/handouts
patient forms/handouts
Below are some forms and handouts that you may find helpful.

  • Communication
    Dr. James Sutton, Medical Director of Pacific Neuroscience Medical Group, has been invited by the Parkinson's Institute to speak on Physician-Patient Communication. The following is a summary of the key points from his presentation. It is our hope that wherever you decide to go for your care, this information will help you to communicate better with your neurologist.

    view physician-patient
    communication guide (pdf)

  • The PAC-25 © 2006 Pacific Neuroscience Medical Group
    The PAC-25 is a survey of 25 symptoms, created to help us monitor and manage patients with Parkinson’s disease and related conditions. It contains a list of symptoms that are sometimes part of Parkinson’s disease, sometimes the result of medications, and sometimes a combination of the two. We ask our patients with Parkinson’s disease to complete this before each appointment.

    view PAC-25 form (pdf)

  • Parkinson’s Questionnaire:
    Activities of Daily Living

    This questionnaire is a modified version of the “Assessment of the activities of daily living to help evaluate disease progression and effectiveness of therapy for Parkinson’s patients” questionnaire, by Stanley Fahn, MD. That questionnaire was itself a modification of a research tool developed by leading Parkinson’s disease experts, used both to measure the effect of experimental Parkinson’s medication, and also used to monitor the progress of patients with Parkinson’s disease in specialty centers around the world. It contains a list of thirteen domains that can be affected in patients with Parkinson’s disease. We also ask our patients with Parkinson’s disease to complete this before each appointment.

    view Parkinson's questionnaire (pdf)

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