At River North Interventiuonal Pain Management Consultants, S.C.,
we truly appreciate your referrals, and strive to rapidly accommodate
your Patient's needs.

As you know, pain is a devastating and incapacitating experience, and
therefore we try to see your Patients on an semi-urgent basis.
To accommodate your patients promptly, our contact person is readily
available either on our office or on her cell phone/page number.

In order to further expedite the care of your Patient, we need your
cooperation :

You would need to fill and either fax or email us a FAX/Sheet form
which can be printed from the link below.

We also need all of your patient's  relevant information  such as:
  • Patient's address and phone numbers
  • Insurance Information
  • Diagnosis
  • Medications he/she in currently taking
  • Copy of the referring physician's notes
  • Copies of any available Mr's, X-Rays, or CT scans.

Finally we would need the procedure requested by the referring

If your patient is a Workers Compensation case, please take a minute
to verify his or her benefits.
Contact Information
Workers Comp. Verification Form
To our Referring Physicians
Fax/E-mail Scheduling sheet