NEW patient consultation

WHAT TO BRING TO THE FIRST VISIT:

  • Insurance Card
  • Drivers license or valid photo identification
  • Payment for any applicable co-pays
  • Any relevant MRI/CT/X-ray or other studies including lab work

Requesting
Consultations:

A new patient requesting a consultation with Pima Pain Center that has an HMO insurance policy should contact their Primary Care Physician (PCP) to refer them to pain management. A referral is required with this type of policy. In addition, please have your primary care doctor fax the following to the New Patient Department: 520-399-6002

  • Progress notes
  • Radiology
  • Demographics
  • Insurance information

  • Medication list

PPO INSURANCE POLICY

A new patient requesting a consultation with Pima Pain Center that has a PPO insurance policy (most of the time) will not require a referral from a Primary Care Physician (PCP); therefore you can self-refer by filling out the form provided on this page. If you have been treated by a primary care, urgent care or emergency room doctor for pain, we will request medical records and will need to have them prior to scheduling your appointment. Pima Pain Center prefers to have as much information as possible to better serve you.

If you have seen a Pain Management Doctor before, you are to provide that doctor’s name, the last time you were seen and reason for leaving his/her care. Please be aware we will request medical records from former pain doctors.

REFERRING NEW PATIENTS

For doctors referring new patients, please fax the following information to 520-399-6002:

  • Last three (3) progress notes
  • Any radiology pertaining to patient’s pain
  • Demographics with insurance information (copy of insurance card preferred)
  • List of medications

**A scheduler will call the patient to set up an appointment and notify the referring doctor of appointment confirmation.**

REFERRAL FORM