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Agatha Namath NPI# 1528055027Michael Lott NPI# 1316122922Virlyn Bishop NPI# 1255516183REFERRAL / CONSULTATION REQUEST Please fax referral to 770.575.3912 Patient Name:___ DOB:___Address:___ Patient
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To fill out the referral consultation request on www.atlantaspinepainmd.com, follow these steps:
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Visit the website www.atlantaspinepainmd.com.
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Navigate to the page 'Referral Consultation Request'.
04
Click on the 'Fill out form' or 'Request Consultation' button.
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Fill in your personal details such as name, contact information, and preferred appointment dates.
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Provide information about the patient, including their medical history and reason for referral.
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Wait for a response from Atlanta Spine & Pain Management regarding your referral consultation request.

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Anyone who wishes to request a referral consultation from Atlanta Spine & Pain Management needs to fill out the www.atlantaspinepainmd.com referral consultation request. This can be patients seeking specialized pain management, physicians referring their patients for consultation, or anyone seeking expert medical advice and treatment for spine and pain-related issues.
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The referral consultation request is a form used to request a consultation with a specialist at Atlanta Spine and Pain Management.
Healthcare providers and medical professionals are required to file the referral consultation request.
To fill out the referral consultation request, you need to provide patient information, reason for consultation, and contact details.
The purpose of the referral consultation request is to facilitate communication between healthcare providers and specialists for patient care.
The referral consultation request must include patient demographics, medical history, reason for consultation, referring provider information, and preferred appointment date.
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