Request an appointment

New or established patients can use the patient portal to conveniently schedule appointments at our office.

An appointment can also be requested by e-mail ( or by calling 832-730-PAIN (7246).

The following information will be required to schedule an appointment:

A. Referring physician information: Name, address, phone and fax number.

B. Patient information: Name, date of birth, phone number, e-mail (if available), mailing address, medical insurance details (plan name, group / member ID number; if none - indicate self pay)

Physicians' offices seeking a consultation for their patients are kindly requested to complete the referral form below and return it to the office along with additional information listed on the form.

Referral form pdf

New patient packet is available for download by clicking the link.

Additional forms are also available for download. 

Please have prior medical records including reports of any studies (laboratory investigations, imaging studies etc.) forwarded to our office by fax (844-302-5696) or by e-mail (