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Refer a Patient to the Pain Management Center

Now Taking Physician Referrals

Learn more about patient safety precautions, virtual visit options, and referring physician resources.

To refer a patient online, please fill out the information below and click on the button labeled "Submit". You will receive a response within one business day. Please be aware, we can only respond to your request during normal business hours, 8 am–4:30 pm, Mon–Fri. 

Please fax the patient's demographics, past medical history, and information about their last physical to 801-585-3274. You may call the clinic at 801-581-7246 for general questions. 


Patient Information

Referring Physician Information