Doctors Pain Clinic

Getting You Back to a Pain-Free Life
888-784-4312

Doctors Pain Clinic Doctors Pain Clinic Doctors Pain Clinic Doctors Pain Clinic Doctors Pain Clinic Doctors Pain Clinic

Patient Info + Forms

New Patients ▸

A Physician Referral is required to see one of our pain management specialists. Request a referral to Doctors Pain Clinic from your primary care doctor or download and print our Referral Form. Take the Referral Form with you to your next appointment with your Primary Care Doctor.

Questions? Please don't hesitate to contact our Main Office:
New Patient Appointment Desk
Toll Free: 888-784-4312 Ext. 103

Read our Patient Quick Guide with frequently asked questions about what to expect from referral to initial consultation and beyond.

Patient Bill of Rights

Release of Medical Records Form

Federal Trade Commission Red Flag Rules


 

 

Current Patients ▸

Online Bill Pay Portal

24-Hour Access to Your Health Information.
The online DPC Patient Health Information Portal provides secure, easy and private access to your personal DPC health information – 24 hours a day!

Insurances Accepted
Doctors Pain Clinic accepts commercial insurances as well as Medicare, Medicaid and Workers’ Compensation. Payment plans are available upon request.

Please Note: Not all insurance plans are accepted at all Doctors Pain Clinic office locations.

Questions about a particular insurance?
Toll Free: 888-784-4312
Phone: 330-629-2888

Changes in insurance: Any changes in insurance provider, home address and telephone number must be reported to the billing department.

Patient Bill of Rights

Release of Medical Records Form

Federal Trade Commission Red Flag Rules


 

 

Patient Billing ▸

PAYMENT METHODS ACCEPTED: Cash, Personal Check, MasterCard, VISA, and Discover Card.

ONLINE BILL PAY: Use our secure, online bill portal.

CO-PAYS: Must be paid in FULL on the day of your visit.

NO-SHOW: If you do not cancel 24-hours before your scheduled appointment, you will be charged a $25.00 service fee.

BALANCES: A payment must be made toward your balance at every visit or future appointments will not be scheduled.

COLLECTIONS: If you are in collection, appointments will not be scheduled until your balance is paid in full.

PAYMENT PLANS: Available upon request.

QUESTIONS?
Billing Department
Toll Free: 888-784-4312
Phone: 330-629-2888 Ext. 121

 

 



Patient Forms


Physician Referral Form
Patients: select the referral form with location you would like your physician to refer you. Take the form to your primary care physician to obtain a referral.


Authorization for Release of Information


Annual Patient Forms
Effective every January 1st, existing patients are requested to complete the forms below for each year. Please print and complete before your next appointment.

 

Back To Top
Doctors Pain Clinic

Main Office:
1011 Boardman-Canfield Road
Youngstown, Ohio 44512

Phone: 330-629-2888
Toll Free: 888-784-4312
Fax: 330-629-8940

 

Copyright © Doctors Pain Clinic. All rights reserved.
Privacy Policy | Terms of Use | HIPAA | Contact Us