Request an Appointment

Conejo Pain Specialists Medical Group, Inc.

Telephone: 805.497.8616
Fax: 805.496.5585

Conejo Pain Specialists Medical Group welcomes new patients.  To request an initial consultation you may contact our appointment scheduler at 805.497.8616.

Comprehensive Medical History Form

We encourage you to print this comprehensive medical history form (New Patient Packet) complete it and bring it with you to your appointment.

Medical Records Request Forms

To authorize your medical information to be sent to our offices, please download and complete our Medical Records Release Authorization form.

To authorize us to release your medical information to another facility, please download and complete our Medical Records Release Form.

Physician Referral Form

If your physician has prescribed a specific procedure, please call Saxon Surgical Center at 805.241.0151 for scheduling.

For spine procedures referred by your physician, please click here to access the Physician Referral Form.Please request that your physician print and complete the physician referral form and fax it directly to Saxon Surgical on 805.241.0161.

Connecting Conejo Pain Specialists with Your Primary Care Physician

If your primary care physician, treating practitioner, or insurance provider wishes to contact Conejo Pain Specialists Medical Group directly to make a referral or request an appointment, the following information is needed:

• Complete medical history
• Copies of completed imaging studies and reports (i.e. CT scan, MRI)

*You (the patient) may be asked to complete a Medical Records Release form to permit your physician or practitioner to release your records to Conejo Pain Specialists Medical Group.

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