Refer a Patient

Refer a patient to the New Mexico Center for Pain & Wellness using one of the options below. Call us any time at (505) 322-6687 if you require assistance.

Referral Form

  1. Download the referral form by clicking here.

  2. Complete the form digitally or print and fill it out manually.

  3. Submit the completed form by fax to (505) 369-3406 or Email to scheduling@nmcpw.org.

  4. A member of our team will connect with the patient to schedule their appointment.

Online Form:

  1. Complete the form below and click submit.

  2. If available, please send patient face sheet/demographic & imaging reports by fax to (505) 369-3406 or Email to scheduling@nmcpw.org.

  3. A member of our team will connect with the patient to schedule their appointment.