♦ For Health care provider
Please provide the information requested in the Amara Pain Spine (APS) Referral form below.
We will schedule appointments at the latest available free spot.
♦ Please click below to download Referral forms
For appointments with pain doctor for pain relief call us at – 704 503 9338
6429 Bannington Road, Suite B, Charlotte, NC 28226
Phone – 704 – 503 – 9338
Fax – 704 – 503 – 9339
Email – firstname.lastname@example.org
♦ Pain Patient Instructions
Notify our pain center staff prior to your appointment if you require special assistance (i.e., wheelchair, interpreter, etc.).
Please download our Amara Pain & Spine- APS New patient intake form above and start filling out pertinent information.
Bring your Amara Pain & Spine – APS New patient intake form and arrive 30 minutes prior to your appointment to allow time for registration.
Please bring your insurance card, copay amount, current list of pain medications and dosages, previous medical records including Labs, CT, MRI, Xray, Physical therapy or chiropractic records, recent doctors or healthcare provider notes, previous surgery reports, medication bottles.
See what Back pain patients say after referral