Request an Appointment
FOR AN INITIAL APPOINTMENT:
**If your insurance requires a referral to see a specialist, we will not be able to schedule an appointment until we have received a referral from your primary care provider along with any imaging reports, so please contact your PCP to send these by FAX to (501)-224-4003
You will need the following to schedule an initial appointment:
1) INSURANCE: Bring your current insurance card
2) CELL PHONE: We will need a cell phone number which can receive texts about your appointments. We will NOT communicate confidential personal health information (PHI) by text, only appointment info.
3) EMAIL: A valid email address as we will be sending you information about your upcoming appointment. We will NOT communicate confidential personal health information (PHI) by email, only appointment and insurance information. If you do NOT consent to communicate appointment info by this means, do NOT give us your email.
NO MEDICATION WILL BE DISPENSED OR PRESCRIBED TO ANY NEW PATIENT UNTIL WE HAVE RECEIVED THE REQUESTED DOCUMENTATION OF SPINAL PAIN FROM THE REFERRING OR PRIMARY CARE PROVIDER. IT IS THE PATIENT’S RESPONSIBILITY TO GET THESE FROM YOUR OTHER PROVIDER.
We will continue our long-standing practice of requesting these on your behalf, but we find some offices typically do NOT send the required documentation. In this case, the patient will be responsible for obtaining necessary records and reports needed for your evaluation.
REQUIRED DOCUMENTATION TO RECEIVE MEDICATION OR PROCEDURES:
This information is requested BEFORE YOUR INITIAL VISIT, but is REQUIRED before you will be prescribed any medication or treatment.
1) You must have a primary care provider. We will need visit notes from your PCP for a visit within the last 12 months to validate you are under the care of a PCP.
2) You must have documentation of back pain. We will need an imaging report (not the image), or the PCP note must clearly document back pain.
3) No prior history of non-compliance with prescription pain medications.
4) No prior history of alcohol abuse or illegal drug use.
You may mail or fax all documents to us, or bring them to your initial visit. (Emailing these documents is not HIPAA-compliant and patient assumes the risk for sending personal health information (PHI) by that means).
Questions about becoming a new patient, email us at firstname.lastname@example.org.