New Patient Registration


 

Thank you for choosing Commonwealth Pain & Spine, where we are dedicated to

 

 

A complete referral consists of the following:

  • Demographics (ie: Name, Address, SSN, etc.)
  • Insurance Card (s)
  • Recent office/progress notes on pain history
  • Applicable imaging

 

Please fax referral to 866 My Pain 4 (866-697-2464)

You may also Click Here to fill out our Appointment Request Form

To contact New Patient Scheduling Directly CALL: 502-890-5639 or EMAIL: newpatients@mypainsolution.com

New Patients: Please remember to bring a valid form of photo ID to your first appointment. Below are acceptable forms. It must NOT be expired.

  • State DMV issued Driver’s License
  • Kentucky ‘REAL ID’ issued by the state DMV
  • CDL License issued by the state DMV
  • Kentucky Identification Card issued by the state
  • U.S. Passport book or passport card issued by the Department of State
  • US. Department of Defense ID
  • US. Citizenship and Immigration Services Employment Authorization Card
  • Veteran Health Identification card

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CP&S NEW PATIENT LETTER

CP&S PATIENT BILL OF RIGHTS AND NPP