Refer a Patient


Thank you for your interest in making a referral to Interventional Spine Medicine, New England’s premier pain management practice specializing in treatment of painful disorders of the neck, back and other parts of the body.


To make a referral, just follow these simple instructions:

  • If you do not already have Adobe Acrobat® Reader installed on your computer, click here to download it for free.
  • Download our Consult Request Form, print it out and fill in the required information. Please include relevant clinic notes and diagnostic study results.
  • Fax your completed referral form to us at (603) 664-0101. If you have questions or concerns, or want to discuss a referral, please call us at (866) 335-5600, or (603) 664-0100


Contact Us : With four locations in New Hampshire (Barrington, Rye, Plaistow, Gilford) we conveniently service a wide area. Contact us today to schedule an appointment for your patient at (603)-664-0100


Our Approach: Learn how ISM’s focus on the state-of-the-art treatment options as well as our patient focused approach leads to a better overall experience for our patients

Our Locations

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