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Medical records greatly assist the doctor in evaluating your current medical condition with formulating your individualized treatment plan. In addition to records from your primary care doctor, please send over imaging studies (MRI, X-rays, CAT scan etc.), previous visits to pain management doctors or any other specialist.   

Patient Forms

The Health Insurance Portability and Accountability Act (HIPAA) provides consumers with important rights and protections concerning their health information.  It outlines controls on how health information is used and disclosed by health care providers.  To comply with HIPAA laws, we ask you to please use the form below to authorize the release of your records.

You may refer patients to our office by filling out the downloadable form below.  We will contact your patient within 24 hours of receiving it and provide your office with notes.  We thank you very much for your trust and to participate in the care your patients.  We encourage you to contact us should you ever have a question in the care our mutual patient.

Doctor Referral Form

We only accept medical records at the Pasadena location.  Please fax records to 713.475.8688

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