Referrals Made Simple

Referrals Made Simple


At Alabama Pain Physicians, we believe referring should be simple. We have created easy to use Referral Forms that are built to take the hassle out of continuing on your patient’s Pain Management needs. Follow the instructions below to use our referrals made simple process. Providers can fill out our Online Referring Provider Form found here.

Step 1: Click the Image located on this page to download the form.

Step 2: Fill out the form digitally on the computer or printed with a pen.

Step 3: Save the form to your patient’s records for your own copy.

Step 4: Fax the form to (866) 702-0880.

You are also welcome to call our phone number at (205) 332-3160 and refer through our call center verbally if you’d like.

Thank you!