For Referring Physicians

Dear Referring Physician,

Thank you for your referral, we are happy to provide the best comprehensive evaluation.

Please have patient contact office directly at 919-681-4986 TWO days after sending records to receive appointment. Dr. Lad sees patients at the Duke Clinic on Thursdays and Beth Parente, PA sees patients on Mondays. 

ALSO INCLUDE MRI, CT, OR MYELOGRAM REPORTS WITHIN LAST (18) EIGHTEEN MONTHS, ANY PREVIOUS OPERATIVE REPORTS AND CURRENT MEDICATION LIST. REFERRAL WILL NOT BE PROCESSED OTHERWISE.

Please prepare by providing the following information:

Referral from a physician is required

Recent clinic notes

Any scans that patient has had related to the reason that they are seeing us. We will need the actual images as well as the report

If patient is being referred for a permanent implant of a stimulator after a trial, then we will need a copy of the psychology evaluation as well as the trial notes and any associated images from the trial available

Please fill out this form completely and fax back to 919.681.1236.

Download the physician referral form

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