Documents Required for Referral:

Center for Pain Management (CPM) referral form
Last 2 office visits
Any imaging reports
Patient demographic sheet
Copies of insurance cards
For lock-in program patients referral form from the primary care needs to be sent directly to the insurance with approval from the insurance sent to us

Patient Forms

Referral Form (pdf)

New Patient Packet (pdf)

The Center for Pain Management

440 B High St, Bowling Green, KY 42101, US

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