Patient Referral Form

Thank you for choosing the Joint Relief Institute as a trusted partner in providing knee pain relief for your patients. Our referral form is designed to make the process simple and efficient, allowing your patients to start their journey to relief with ease.

To refer a patient, please download and print the referral form below. Once completed, simply provide the form to your patient with instructions to call our office to schedule their first appointment. We’ll take it from there, guiding them through every step toward personalized, non-surgical knee pain relief.

What to expect for your patient:

  • Quick Appointments

    Patients are typically seen within 24 hours of their call.

  • Same-Day Relief

    Many patients receive treatment on their first visit.

  • Insurance Support

    We offer full insurance verification, including Medicare coverage with no out-of-pocket cost for those with supplemental insurance.

Download and Print Form

Our team is here to ensure your patients receive compassionate, expert care backed by our advanced technology. Thank you for trusting us to support your patients’ health and well-being.

Download Referral Form