Information for Referring Physicians
Access important resources and information here.
At Regional Brain & Spine, we are proud to partner with your practice and provide the highly specialized care your patients deserve.
A team approach ensures optimum care
Regional Brain & Spine’s advanced practice nurses and certified physician assistants are a critical component of the care we provide. These professionals work closely with our surgeons and physicians to deliver essential assessment and treatment. This unique team approach helps ensure that your patients receive optimum care.
The referral process
Our team is committed to making the referral process simple and efficient for you and your patients.
Option A: Call new patient scheduling at (573) 332-5636
(1) Download and complete the appropriate Consultation Request Form below:
- “Neuro Consultation Request Form” here [pdf]
- “Pain Management Consultation Request Form” here [pdf]
- “Physiatry Consultation Request Form” here [pdf]
(2) Gather your office’s last Encounter Note and if present latest Imaging Report
(3) Fax completed Consultation Report along with documents from Step 2 to: 573-339-9709
(4) If present remind patient to bring their Imaging Disk with them to appointment scheduled at Regional Brain and Spine
The information that will be requested when you refer includes the patient’s:
- Name & date of birth
- Address & phone number
- Social security number
- Insurance provider’s name & contact information, if available
- Reason for visit
- Previous neurological surgeries
- Imaging tests/treatments patient has completed