Please use this form for questions or to request an appointment.

Just fill out the contact form below, making sure to include your name and best phone contact. If you have a symptom or pain problem and wish to make an appointment, please describe it below and we will get back to you within 24 hr. (except on weekends) to discuss it with you. We respond to all submitted forms. If you are having an emergency, please call 911 or go to the nearest emergency room. Do not use this form for emergencies. The information you provide here is protected under HIPPA regulations for health information and is strictly confidential.

* Required fields
Name *
E-mail Address *
Best Phone for Contact *
Best Time To Contact	Morning Afternoon Evening Weekend Day Weekend Night
Time Zone	PST EST GST
Main Problem *	Headache Migraine Back Pain Neck Pain Leg Pain Sciatica Arm Pain Numbness in extremity Tingling in extremity Carpal tunnel syndrome Radiculopathy Disc problem Pinched nerve Several of the mentioned problems above RSD or Complex Regional Pain Nerve lesion Neuropathy Other None of the above Need to be called for a question
Questions / Comments/Describe your symptom or pain problem here
Preferred Location for Appointment	Pasadena Medical Center Houston Any-First Appointment available
How did you hear about us? *	GOOGLE search YAHOO search MSN search Spine Universe Website Wellness.com website Facebook Another website Relative or Friend Your primary care doctor Other

I have read and agree to the Privacy Policy *

Spam prevention

Please enter the code shown above and click the 'Submit Form' button. This additional step is required to help protect against message spam.

Enter code above:

Please use this form also if you want to make a comment or give us feedback about anything. We’d love to hear from you.

Discogenic Pain | Degenerative Disc Disease | Herniated Disc | Nucleus Pulposus | Spinal Stenosis | Spondylolysis |   Spondylosis | Fibromyalgia Syndrome | Osteoporosis | Vitamin D Deficiency | Sacroiliac Joint Dysfunct | Sciatica Pain | Chronic Pain Management | Epidural Injections | Joint Injections | Facet Joint Injections | Discography | Prolotherapy | Physical Therapy | Trigger Point Injections

2011 © Copyright. All Rights Reserved Houston, Texas