Thank you for allowing Revival Pain Management to assist in alleviating you pain. Our Board-certified physicians and highly trained staff are committed in providing professional, compassionate care.
New Patients Being Accepted by Referral!
New Patients: Please note that this practice requires a referral from your treating physician before your new patient appointment can be scheduled. If you would like to speak with your treating physician about Revival Pain Management, you can download our Physician Referral Form here to provide it to your doctor. This will ensure a smooth process to start the road of recovery and pain management care.
To help make your visits to Revival Pain Management run more smoothly, please arrive 15 minutes prior to your appointment time, and bring the following to your appointment:
- For first visits, your packet of intake forms (see below)
- Your insurance card (see list of accepted insurance below)
- A list of medications you are currently taking, including prescription and over-the-counter
We look forward to assisting with management of your pain in order to get you on a better quality of life!
Patient Intake Forms
In order to help you arrive well prepared for your office visit at Revival Pain Management, we have provided our necessary intake forms below. Please download, print and complete these prior to your visit.
If this is your first visit to Revival, use only the INITIAL VISIT PACKET. If this is your follow-up visit, use only the FOLLOW-UP VISIT PACKET
If you are unable to print the forms, arrive a few minutes early to your visit. We will have the forms available in the office.
Revival Pain Management accepts most major health insurance plans, as well as Medicare and Medicaid. The following is a list of the most common insurance plans we accept. This list is for reference only and is subject to change. Revival Pain Management may participate in some, but not all, products offered by a health insurance plan. For questions about your specific insurance plan’s coverage and your specific plan’s network, please contact your insurance carrier directly.
- Aetna Medicare
- BCBS of NC
- First Health
- Humana (commercial)
- Humana Medicare
- NC Medicaid/Carolina Access
- VA Medicaid
- VA Premier
- VA Medallion
- United Healthcare