Referring Physicians


Use our toll-free, dedicated new patient fax line: 866-MyPain4

or Click Here to fill out our Appointment Request Form


The entire staff at Commonwealth Pain & Spine is committed to providing best-in-class service to our referring physician partners.

We pledge to:

  • Provide your patient with quality care and timely consultations
  • Communicate back to you swiftly and accurately
  • Fast track procedures as necessary and when in patient's best interest
  • Return the patient back to your care


Our scheduling staff is devoted to finding appointments for new patients within ten business days of referral or initial contact.

Patient referrals are accepted via facsimile to our dedicated new patient fax number, 866-MyPain4, (866-697-2464). If you are referring a work comp patient, please fax to 502-919-9751.

You can also Click Here to fill out our Appointment Request Form.

In order to schedule your patients as quickly as possible, it’s important that you provide as much information as you have available.

Our referral form is available for download below:



Please ensure that you have provided:

  • Accurate patient demographic information including date of birth, age, gender, social security number, address and any phone numbers you have on record
  • Insurance information - preferably a copy of the insurance card
  • Diagnostic studies, including any and all MRI, CT, or any other records the patient may have if you are referring to a specific procedure. We can always do an evaluation without diagnostic imaging




Commonwealth Pain & Spine is an in-network provider with most insurance companies, including but not limited to:

A Self-Pay option is available to accomodate uninsured patients only.