AIS™ is committed to supporting providers and their patients with implanted pumps with the PainCare™ medications and PainCare resources they need.
New Account Checklist
Outlines the forms needed to open an account with AIS. Also details service tools and programs offered by AIS which will be discussed as part of the new account setup process.
Provider Profile Form
Required for all providers and clinics that are new to AIS™. Information provided is used to create a customized Rx form and login information for access to AIS's Provider Portal.
Clinic Information Update Form
Have you changed your clinic email address, mailing address or fax number lately? Have you had any personnel changes? Have your hours or preferred delivery days changed? We like to stay up to date on how to properly contact you so that both of us are in compliance with HIPPA privacy laws. Please let us know so that we may send communications through the proper channel and protect your patients' privacy. Please complete this form as soon as possible and return it to the address or fax number (ATTN: Heather, Lauren & Melinda) below.
If you do not see what you need in the list above, please contact AIS directly and we will gladly assist you.
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As a trusted partner, AIS™ is "Leading the Way in Intrathecal PainCare™" by providing patient-specific intrathecal medications in support of hospitals and providers and their patients with implanted pumps.