Forms to fill out

AUTHORIZATION OF DISCLOSURE / RELEASE OF HEALTH INFORMATION FORM

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CONTACT INFORMATION FOR MEDICAL HISTORY

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PATIENT REFERRAL FORMS

If you are a healthcare professional or clinician (such as a representative from a physician practice, insurance provider, employer, or a health plan case manager) referring a new patient for treatment, please fill out the relevant Patient Referral Forms and fax them to (480)745-7871. (Center for Pain Management does not require new patients to have a referral; however, some insurance plans may). 

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FREQUENTLY ASKED QUESTIONS

New patients often have questions about insurance, our practice, or the services we offer. You may find the information you’re looking for in this list of frequently asked questions.