Become A Patient
Thank you for selecting Advanced Spine & Pain Centers for your pain care. To schedule an appointment, please call us at (501) 219-1114 or use our online appointment request form.
Once you have made your initial appointment, you may pre-register online by completing the interactive forms below, or you may download and print the forms, fill them out and bring them with you to your first visit. Completing the forms prior to your visit will help speed up the new patient registration process. Please also see the New Patient Requirements below.
- Request An Appointment
- New Patient Registration
- Physician Referral Form
- Medical Record Request
- Patient Satisfaction Survey
New Patient Requirements
To best serve our patients, we collect a detailed history of your condition before your appointment. We will need you to send the following information to our office for our doctors to review:
- Medical documentation of cause of pain (this could include diagnostic studies, radiology, surgical history and/or medical history)
- Clinical history from any prior pain management clinic
- 12 month pharmacy history
- MRI, CT or other diagnostic testing of the problem area taken in the last four years
This information is gathered to ensure your safety and to help our doctors develop the best course of treatment for you. In addition,
- You must be established with a primary care physician.
- If you have had recent surgery, you must have medical clearance from the surgeon to be treated at our practice.
After we receive your information, our medical staff will review it and if you are qualified, we will contact you to schedule an appointment.