Provider Referral We are dedicated to working with providers like you to offer your patients comprehensive pain care of the highest quality. Please submit the following along with your referral request: A complete provider referral form Recent/ relevant typed clinical notes or test results Proof of insurance Authorization information with CPT codes and details ONLINE FORM(opens in a new tab)(opens in a new tab) Have Questions? Give us a call and we will assist you with the enrollment process! (770) 679-7000
