Fax Referral Form and Informational Patient Handouts

Physicians may refer a patient to our office by telephone or by fax, whichever is easiest for your office. We have developed a Fax Referral Form to assist your office staff, using information and suggestions from some of our referring offices. The form is in Adobe Acrobat pdf format. If you do not already have Adobe Acrobat on your system, you can download it free by clicking on the Adobe Acrobat link at the bottom of this page.

The Fax Referral Form can be printed by clicking on the link below:

        Fax Referral Form

Printable Informational Patient Handouts:

        Pain Management Information Sheet

        Epidural Steroid Injection Information Sheet

        Facet Joint Injection Information Sheet

        Lumbar Sympathetic Block Information Sheet

        Selective Nerve Root Block Information Sheet

        Stellate Ganglion Block Information Sheet

Informational Patient Handouts have all been designed to provide information to your patients and thereby save you and your staff time when referring patients to Pain Diagnostics and Treatment Center, PA. These are in Adobe Acrobat pdf format. If you do not have Adobe Acrobat on your system, you can download it free by clicking on the Adobe Acrobat link at the bottom of this page.


       

Pain Diagnostics and Treatment Center, PA

   7777 Forest Lane, Suite C-502
   Dallas, TX 75230

   2241 Peggy Lane, Suite A
   Garland, TX 75042

   Phone: 972-566-8999 Fax: 972-566-8998

    View Map for Directions to our Offices