Pain Institute of Nevada
Thinking outside the pill box.

New Patient Registration form


Please fill in form online, print, and bring with you to your first appointment.   In order to expedite your first visit, please  fax or mail  the completed form prior to your appointment.  Thank you.

Click here to download New Patient Registration Form

Pain Institute of Nevada
600 S. Rancho Dr., Ste. 113
Las Vegas, NV  89106

Fax:  (702) 878-9096
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