Richmond Spine Interventions & Pain Center

14404 Sommerville Ct. 

Midlothian, VA 23113

For Life-Threatening Emergencies Call 911
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© 2017 by Richmond Spine Interventions & Pain Center.

Save time at your next appointment!

Save time by completing your new patient paperwork before your appointment. You can download all your patient forms here:

Insurance Questions?

For more information on insurance plans we accept and other related information, please see our insurance page or speak with our office staff.

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Questions?

For more information or to schedule an appointment, please call one of our schedulers at 804-378-1800

Richmond Spine Interventions and Pain Center is dedicated to providing you with the highest quality service, and provide the most comfortable experience possible.
New Patients:
We ask that your referring physician contact our office to set-up your initial consultation. Your referring physician must fax the following information to our office:
  • Office notes regarding your previous care
  • Recent imaging studies
  • Recent lab work
 
Please bring a copy of your insurance card and a photo ID. We also ask that you bring a list of your current medications including the strength and dosing instructions.
 
If your insurance requires a referral or authorization number from your primary care physician you must obtain this prior to your office visit.
 
Self Referral Patients:
If you are a new patient that is not being referred to us by another physician you must fill out a Self Referral Form. This form must be filled out completely or your request will be delayed. Our physicians will review this information to ensure that they are able to provide you with the care that you need.
 
If our providers feel they can help you, our schedulers will call you to schedule an appointment. If your appointment request is approved you will need to provide all relevant medical records pertaining to your care (past and present). Please be sure to gather all records for the physicians to review prior to your appointment. 
 
This process can take up to 14 business days. We DO NOT inform patients whose self-referral form was rejected, you may call the office after the 14 day processing period to check the status of your request. 
 
You can download the Self Referral Form by clicking the link to the right.
Once completed in its entirety you can send the form to us via:
Fax: 804-378-5400
Email: fax@backpainva.com
Mail: 3420 Pump Rd. #160, Richmond, VA 23233
Drop-Off: 14404 Sommerville Ct. Midlothian, VA 23113
 
Co-Payments and Deposits: 

 

  • Insurance co-payments are due at the time of your visit. If you are unable to provide this please call to reschedule your appointment.

  • Patients with high deductible insurance plans may be asked to make a deposit prior to your appointment or procedure. If you have a high deductible plan our billing office will call you prior to your appointment to inform you of any deposit due and will assist you with any payment arrangements. 

  • We accept all major credit cards.

  • There will be a $25 fee for any returned checks.

New Patient Information