Your Visit

Scheduling Your Appointment

Pain Relief of Dayton is accepting new patients, and non-physician referrals are always welcome! To schedule an appointment please call 937-395-1300.

Click here to get directions to our office. Ample parking is available.

Missed Appointment Policy

Not keeping scheduled appointments hinders our ability to provide quality care. Therefore, we require a 24-hour notice for all cancellations. This allows us sufficient time to offer your time slot to another patient. Failure to provide cancellation notice within the required time frame will result in a $25 fee being assessed to your account. This is not payable by your insurance carrier and will be your responsibility.

Insurance

Pain Relief of Dayton accepts most commercial insurance plans, Medicare and Ohio Workers Compensation. Many insurance companies require prior authorization for treatment. Please check with our staff if you have questions.

Financial Responsibility

All professional services will be billed on your behalf to your insurance plan on file. Any amounts not covered by your plan such as co-payments, co-insurance, deductibles, or plan exclusions are the responsibility of the patient. These amounts may be collected at the time of service. Patient accounts over 60 days due will be considered delinquent unless payment arrangements are made.

It is your responsibility to know your insurance benefits, including whether we are a contracted provider with your insurance company, your covered benefits, and any exclusions in your insurance policy.

Patient Forms

Save time by filling out these patient forms prior to your first visit:

New Patient Forms

HIPAA Privacy Acknowledgment

 

 

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