CALL: 864 373 PAIN (7246)
FAX: 864 286 3077
Forms for NEW PATIENT:
Other health plan patients.
(If your pain is due to an accident or work injury )
(fax this form to your current or past physician who will provide us the medical records free of charge.)
Save time ! Download office forms and fill out prior to visit!!
We welcome you. You save our time by not dealing with third party. We provide the same standard of care as an insured patient. Payment plan available for procedures; sorry no payment plans for office visits. Exclusive Saturday appointments can be requested by email. Self pay agreement / Form
Forms for RETURNING
PATIENTS:
If you are returning after a previous office visit (follow up office visit) please complete this form.
Pain assessment forms / tools provided by external agency. Click here. (Complete one or many these forms upon request)
If you are returning after a pain relieving procedure we wish to learn the progress, please complete this form.
Miscellaneous forms for specific conditions:
If you are an injured worker, you need to obtain the approval of your case worker or claim adjuster. Please provide this form for authorization. Referral by your personal physician alone is not sufficient for work comp patients.
SPC specific forms:
These are password protected forms. Must be completed via our secure site. Password will be provided when the need arise.
Please revisit this page prior to your appointments for any updates.
Almost all our patients are referred by physicians.
We appreciate your referrals. Please fax this referral form to to 864 286 3077. We will contact your patient ASAP. Appointments are given within 7- 14 days. For urgent procedures or injections contact our office directly and speak with the manager.
Referring Physicians
Aathi Thiyaga MD |