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.
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.