Referrals

We at PRIDE know that you want the best for your patients. Please browse around this site to make sure we are the right choice for you, then contact us to make a referral.

4 Easy Ways to Refer a Patient for PRIDE Services:

Phone

214.351.6600

Message

via our Contact page

Fax

Download the pdf-iconReferral Form and Fax to 214.351.6453.

Online Form

Click Here (or just scroll down)

Our goal is to help patients improve their functioning and quality of life through a highly individualized, hands-on comprehensive program.

Referral via Online Form

Referring Information
Financial Class

Early Intervention / Secondary Care

Chronic Pain Management

*includes medication management, physician care, nursing, physical and occupational therapy, case management, biofeedback, psychology, education, MMI and IR when applicable and post-program follow-up.

Individual Services



Physician Preference


*As a service to you, this office will handle all pre-authorization requirements. Please fax this form with patient demographics, all diagnostics, first and last medical reports, operative notes and any impairment/MMI information.

REV 01/06/2017