A patient may be referred by a physician or self referred. We MUST receive the following documentation to schedule an appointment:

• Patient demographics (updated patient contact information)
• Last 3 clinical notes from PCP
• Imaging reports
• Discharge letter from previous pain clinic
• Last 3 clinical notes from previous pain clinic

You may print out our Medical Release Form to request the required documents.

If you have a primary care physician, they may refer you to one of our clinical facilities with this referral form.

Referral Form PDF

Need to request your medical records from your previous physician, forward this form to their office.

Medical Release PDF

Do you have a scheduled appointment and did not receive your new patient packet? Print the packet, fill it out and bring the packet in with you completed. You may give us a call if you have questions.

New Patient Packet PDF

Patients may access their health records, join a Tele-visit, easy check-in, and hassle free appointment booking.  

Patient Portal Access