Refer a Patient

Patient Referral

Always accepting new patients.

Help your patients achieve better living through an individualized, multi-modal pain approach.  Refer a patient by filling out the form below.

Refer a Patient

  • Patient Information

  • This field is for validation purposes and should be left unchanged.

Requests for appointments may be made by a provider referral.

To make an appointment for your patient, you may do one of the following: 

  • Call our scheduling department at 218.894.7730
  • Fax a referral form or your order to 218.894.7734. Please include any clinic notes about pain and any imaging regarding the pain (MRI/CT/XRAYS)
  • Complete and submit the information on this secure referral request.

Questions? Call 218.894.7730

If you are a provider and would like to speak with one of our providers by phone, please contact Jody at our main number above and we’ll return your phone call.