Make an Appointment

To schedule an appointment, please call (800) 446-5684 or use our online appointment registration form below:

Get a head start on your appointment.

Click on the links below to view and print registration forms to bring to your appointment. You will need the free program Adobe Acrobat Reader in order to view these forms. Filling them out at home and bringing them to your appointment will save time and help us keep our appointment schedule for you and other patients.

Please be sure to review our clinic policy for additional questions. Clinic Policy

Registration Forms

Patient Information Patient History Form

Back Forms

Cervical Spine Lumbar Spine Factor of Complaint Pain Diagram

Medical Records

Release of Information (to others)

Privacy Practices

HIPAA Pamphlet

What should I bring to my appointment?

  • Your insurance card or health coverage information. Please note that many insurance carriers require you to have a referral (authorization from your primary care physician) before treatment is provided by one of our specialists. Please check with your insurance carrier if you have any questions regarding your plan or coverage.
  • Referral form if required by your health insurance plan.
  • List of all medications (both over-the-counter and prescription), including doses and how often taken.
  • Any X-rays or MRIs that have been taken for the condition you are experiencing. Please note that the images cannot be older than six months.
  • Clinic notes or operative reports from your referring physician that relate to the condition for which you are seeking medical consultation.
  • Driver’s license and/or government issued ID.

If you have any other questions prior to your visit, please feel free to contact us at (800) 446-5684 and our staff will be happy to assist you.

What happens if I need my physician after-hours?

Emergencies arise occasionally when our patients need to contact our physicians regarding pain or other symptoms. If this is the case, please call Ivinson Memorial Hospital at (307) 742-2141 and the on-call physician will attempt to resolve the issue.

For non-emergency prescriptions or prescription refills, please contact your treating physician’s office and review our clinic policy.

 

Clinic Policy