Patient Referral Form

Please fill out the form below or print and fax the “New Patient Referral Form” to (915) 257-6302.

Referring physicians are welcome to call us any time at 833-339-7246 with questions or concerns about a shared patient or to refer a patient to our care.

Download Referral Form

6955 North Mesa St.
Suite 200
El Paso, TX 79912

7812 Gateway Blvd E
Suite 230
El Paso, TX 79915

(833) 339-PAIN (7246)
(915) 257-6302