For Physicians

It is our pleasure to work with you in addressing the pain management needs of your patients in pain. We offer a vast variety of services including appropriate medication management, cutting edge interventional techniques and comprehensive plans of physical and psychological rehabilitation. Please do not hesitate to call us with any questions regarding your patients currently being treated at Comprehensive Pain Management Center or otherwise. We look forward to our continued working relationship.

Referral form

Please send the following information to FAX #: 408-356-5307:

• Face sheet with patient's demographic information
• Insurance information: Work Comp/Private Insurance/Medicare (copy of both sides of card)
• Insurance Authorization if needed (for HMO's and Worker's Comp)
• Last three months worth of Medical Records pertaining to the reason they are being referred
• MRI Report / EMG Report / X-Ray Report / CT Scan Report, etc.

Once we receive all the information listed above, our office will contact your patient within 48 hours to set up their initial consultation.

Sincerely,

Annu Navani, MD
and the team at CPainMC.

Thank you for your referral!