Kennebec Region Health Alliance

Promoting Healthy Communities Since 1997

Letter to Patient - Chronic Pain

[insert logo]

[Today’s Date]

[Patient Name]
[Patient Mailing Address]

Dear [Patient First Name]

Our office is improving how we help patients manage chronic pain. We have learned a lot in recent years about how chronic pain can be better managed. This had led to a change in state law on prescription pain medicine. We will be working with you to improve your pain care. This may involve changes to your medicines or adding other treatments that you may not have considered.

Our office staff will be calling you in a couple of weeks to schedule a chronic pain visit with your provider. This visit will last 30 to 45 minutes and will focus entirely on your chronic pain. If you have other health issues to discuss, please schedule a separate visit.

Optional Paragraph that can be tailored to the practice:
We would like to learn more about your pain so we can be best prepared for your visit. With this letter are forms that we ask you to complete and bring to your visit:

  • The Initial Pain Assessment Tool shares how you experience pain right now.
  • The Pain Inventory tells us how your pain affects your day to day life and relationships.

Please arrive on-time and with your completed forms for the visit. If you have any questions or need help filling out the forms, please feel free to call office at [insert phone number].

We look forward to partnering with you to improve your health.


Person’s Name
Practice Name
Phone number to contact

Contact Us

Kennebec Region Health Alliance
10 Water Street, Suite 202
Waterville, ME 04901
(207) 873-9842

Compliance Helpline
(207) 621-9870