Emergency referral: If your patient has a diagnosis of shingles (herpes zoster), please let our new patient coordinator know and she will facilitate a same day appointment.
Routine referral: If you would like to have your patient seen at PainCare, fax the following information to:
603-692-3168 (Somersworth, Newington)
603-692-1817 (Plymouth, Lebanon, North Conway, Wolfeboro, Concord)
603-424-8868 (Merrimack, Raymond)
- Patient demographics
- Related office notes from the past 6 months – 1 year
- Hospital admission notes
- MRI/CT/X-ray reports or pertinent labwork
- Insurance referral, if applicable
- Any previous pain clinic records
The patient will be contacted to set up an appointment and will be sent a packet of information to be completed and brought to their first appointment.
If the patient has had recent and pertinent x-rays or MRIs, please remind him/her to bring the films or disk to the consultation visit.
If there are other issues not apparent in the medical records that are relevant to the referral, please feel free to contact the New Patient Referral Coordinator at 692-3166 (424-8866 in Merrimack) to discuss the issues.
You will receive a follow-up “Thank You” letter with the date of your patient’s appointment.