To refer a patient, please fax referral and pertinent clinic notes to the corresponding location below

Attn: Scheduling

Attn: Scheduling

This document is in Adobe Acrobat PDF format and requires the free Adobe Reader to view. If you don’t have Adobe Reader already, you can download it by Clicking Here.

What Do I Need For My Initial Appointment?”

  1. Referral from a physician for pain management
  2. Your most recent clinic notes should be submitted via fax at 866-644-8086 or to
  3. Any imaging you have had in the past 6 months should be sent to us as well.
  4. Authorization of your referral if your insurance requires it.