Thank you for choosing Summit Pain Alliance for your care. Our goal is to provide you with the highest quality medical service.
Making an Appointment
To make a first time appointment, please call our Santa Rosa office at (707) 623-9803. You may need a referral. We will be happy assist you in contacting your primary care physician if needed.
For New Patients
- Referral from your primary doctor
- Patient Demographics
- Insurance Information/Card
- Authorizations, if required by HMO or Worker’s Compensation
- Two recent doctor’s visit notes
- Imaging reports (MRI/CT/X-Rays/Nerve Studies)
- Pain Medicine History (Previous Doctor’s Name and/or Treatments)
For your convenience, forms that are available for download prior to appointment:
Please fill out the Patient Registration Form which includes all demographic information including insurance. This information needs to be completed before you see the doctor on your first visit. Forms may be emailed to our office prior to appointment.