At River North Interventional 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.

Fax / Email Scheduling Sheet

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

Contact Information

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 physician.

Workers Comp. Verification Forms

If your patient is a Workers Compensation case, please take a minute to verify his or her benefits.