Physician Referral

Refer your patients to our board-certified pain management specialists. We make the process simple and keep you informed.

Submit a Referral

Complete the form below and our care coordination team will contact the patient within one business day to schedule their appointment.

Referring Physician
Patient Information
Referral Details

Do not include sensitive medical records in this form. Supporting documents should be faxed separately to ensure HIPAA compliance.

Why Refer to Us

  • Board-certified pain management specialists
  • Prompt appointment scheduling (typically within 1 week)
  • Comprehensive consultation reports sent back to you
  • Collaborative care approach — we work with your treatment plan
  • Full range of interventional and non-interventional options
  • Transparent communication throughout the patient's care

Referral by Phone

Prefer to refer by phone? Call our referral coordinator directly:

(580) 749-9992

All referrals are reviewed for compliance with applicable regulations. No automated compensation or incentives are provided for referrals.