Fill out the form below to request an appointment

Your contact information will be kept strictly confidential. If voice-mail messages are left for you we will identify ourselves as calling from Twin Cities Pain Clinic. A scheduler will contact you by phone within one business day to arrange an appointment date and time.

This form is to be used for appointment requests only.

Name
Date of Birth
Email
Phone – We contact our patients by phone between the hours of 8:00 am and 4:30 pm.