2500 Farmington Avenue
Farmington, NM 87401
p: (505) 326-PAIN
f: (505) 592-0063
Please contact the office and one of our staff would be happy to assist you with making an appointment.
For your convenience you may view and print our new patient forms by clicking any of the buttons below.
Once you have printed and completed the forms, you can fax it to 505-592-0063, email us at firstname.lastname@example.org or bring it with you.
In addition, our physicians will need to review any reports from other doctors, including X-ray, MRI or CT examinations, or other tests that you may have had performed in the past relating to your pain problem.
Please fill out the release of information forms and have them faxed to our office prior to your appointment.
If you need assistance in requesting previous examination reports, please contact our staff at 505-326-7246.
NEW PATIENT FORM
RELEASE OF INFORMATION