Patient Referral Form
To refer a patient, simply complete and submit the encrypted, HIPPA-compliant online form below.
A referral can also be submitted by printing and faxing a referral form to 763.537.6666. For general questions, please call us at 763.537.6000
If you have a patient struggling with chronic pain and you’d like to discuss the case, please call our PROVIDER HOTLINE AT 763-537-1000.
For urgent situations, we will do our very best to see your patient the same or next day.
Once we receive the form, a Nura patient care coordinator will contact the patient and schedule an appointment. At a new patient evaluation appointment, our Medical Director, Dr. Peter Schultz, will see your patient along with an advanced practice provider, physical therapist, and a member of our behavioral health staff.
This multidisciplinary team then creates an individualized, comprehensive Plan of Care; this can include medication management, physical therapy, behavioral health counseling, and interventional procedures as necessary. At that point, we communicate the patient’s plan of care back to you.