Patient Forms
New Patient Forms
Below you will find a few forms that will need to be completed prior to your first appointment with Republic Pain Specialists. Wondering what you expect on your first visit? Contact us today and we’re happy to walk you through the process.
Email Us
For more information about Republic Pain Specialists or to schedule an appointment, please contact us today using the form below or give us a call.
What Our Patients Say…

Went in to see Mr. Gaskin regarding some back pain that I’ve had for years. He heard me out and asked me to do some stretches and movements and figured out that it was my SI joint causing me issues. He gave me a shot that was pain free(because I’m a huge baby when it comes to needles) and I’ve been lower back pain free going on two months now. I would recommend him to anyone having daily pain. Very affordable and a great doctor. I will definitely be back if I have to be.

Went in to see Mr. Gaskin regarding some back pain that I’ve had for years. He heard me out and asked me to do some stretches and movements and figured out that it was my SI joint causing me issues. He gave me a shot that was pain free(because I’m a huge baby when it comes to needles) and I’ve been lower back pain free going on two months now. I would recommend him to anyone having daily pain. Very affordable and a great doctor. I will definitely be back if I have to be.

Went in to see Mr. Gaskin regarding some back pain that I’ve had for years. He heard me out and asked me to do some stretches and movements and figured out that it was my SI joint causing me issues. He gave me a shot that was pain free(because I’m a huge baby when it comes to needles) and I’ve been lower back pain free going on two months now. I would recommend him to anyone having daily pain. Very affordable and a great doctor. I will definitely be back if I have to be.

