Download our referral form below. Fill out the form completely and fax with picture of the patients insurance card, physician notes (within 3 months of referral), recent (within 2 yrs of referral) MRI or other imaging of the affected area . If the patient does not have a recent MRI or xray, please note this on the referral. A complete initial referral is the best way to facilitate timely review and scheduling.
Once we have all that is needed for your referral and have been accepted, our referral coordinator will call you to set up an appointment. At that time you will be given instructions on how to go to our patient portal to fill out your new patient paperwork to submit online. It is very important that this be completed for your appointment. If your online paperwork is not completed by your appointment time, you may be asked to reschedule your appointment.
If you are a patient that requires medication management, we will need a referral from your doctor and your previous pain management notes for the last year. This information is required for the referral process. Once we have all the documents, your referral will then go to physician review where one of our doctors will review your referral and decide the best course of action.
You will need to show up to your appointment 45 minutes early. This is important as we use this time to make sure that your paperwork is complete and finish the check in process. If you are not able to arrive 45 minutes before your appointment time, you may be asked to reschedule.
The ability to treat most diagnoses pertaining to neck, back and/or joint pain without a pain medication prescription. Treatments usually include steroid injections or physical therapy.
Now its our turn !
Please allow up to 10 business days to process the initial referral. We will fax a referral follow up to you detailing the outcome of the initial review, including the patient's appointment details once scheduled. You are welcome to follow up with our referral coordinator after this initial processing period.
Get a referral!
Scheduling and Patient Portal
Currently our practice is only able to process referrals from sources that are part of the UPA network. Click the link below to search the UPA physician listing for your doctor before sending referral.
This is an all inclusive treatment for those that require a more aggressive approach to their pain. Comprehensive could include injections, physical therapy, medication management or other treatment modalities.
Once we have received the completed initial referral, we will review the information and determine if additional details are required. Some referrals may require additional review by one of our Physicians prior to scheduling. Once the referral has been approved for scheduling our referral coordinator will contact the patient and schedule a time that works for them.
1934 Alcoa Hwy, Bldg. D, Suite 474, Knoxville, TN 37920 * Office (865) 305-8684 * Fax (865) 305-8695
Previous Pain Management
For Referring Providers
Our practice requires a physician referral. The referral can come from your primary care physician or a specialist. We do NOT accept referrals from previous pain management doctors. Your referring provider should be in the UPA network. Click on the UPA button to be directed to their website.
865-305-7759 Office | 865-305-8695 Fax
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