How to become a new patient:
Before you are accepted as a patient for a pain management evaluation, our doctor will review your medical records to determine if you are a candidate for our services.
Self-Referred patients with Medical Insurance: (We do not accept Cash Only or Medicaid patients)
Request your current doctor fax:
- Your medical records pertaining your pain
- Last 3-6 months Medication list
- Recent (6 months) MRI, CT, X-Ray or nerve conduction studies.
You can also sign a request for the release of your medical records and we will obtain your medical records for you. Please stop by one of our locations and speak with the receptionist.
Physician Referred: We work closely with your doctor to coordinate your care. Your records are reviewed by our doctor. We contact you with a final determination.
Workers Compensation: Your adjuster or case manager must contact us to request an evaluation of your records. Once accepted as a patient we will contact you for an appointment. Please note that all appointments will be authorized in writing by using our special authorization form. The form needs to be signed and services authorized before we schedule your appointment.
Auto Accident: We do not accept Letter of Protection (LOP) at this time. You need to have health insurance in order to be seen as a patient. Your medical records will be evaluated to determine if you are a candidate for the clinic. Please call our office for further instructions on how to become a patient.
HMO Insurance Patients: All visits need to be authorized in advanced. Please contact your primary doctor and request a referral to pain management. Once you are accepted as a patient, we will request all authorizations before your visits.
Out of Network Patients: As a courtesy to our prospective patients, we verify that your insurance company covers your insurance and our services. In the event your insurance is out of network, we will notify you of your financial responsibility before an appointment is scheduled.
New Patient Forms:
New Patients with a scheduled appointment:
Please print and complete these forms and bring them to your first appointment. It asks for information about your current problems and past medical history. It will give your doctor a better understanding of your problem, and will allow us to spend more time discussing your treatment with you.
Please bring to your appointment the following:
- A picture ID
- Insurance cards
- Medications you are currently taking
- Test results (films, CD)
- Completed New Patient forms
- Please contact us in advance, if you need special accommodations such as a wheelchair, assistance with paperwork or an interpreter.
- Expect to spend 1-2 hours in our facility as a New Patient.