- Guidelines for Referrals
- Consult Request
- Authorization for Disclosure of PHI (Medical Records Release)
- Authorization for Disclosure of PHI (Medical Records Request)
- Patient Request for Treatment Release
To Our Referring Physicians
Your referrals indicate your confidence in the treatment your patient will receive from our practice. Your patients are welcomed by our friendly and proficient staff to a pleasant environment and private office setting. We offer a conservative clinical approach to achieve positive long term results for your patient. Every effort is made to communicate with you and keep you continuously updated with each patient encounter. We appreciate the opportunity to provide interventional pain management services for your patients.