Online Contact Form
Use this form if you have non medical questions related to scheduling an appointment, billing questions, RSVP to an event or if you are a physicians office and would like more information about our practice. Patients interested in setting up a new patient appointment or a non urgent routine appointment may do so by using this online form.
Allow at least 2 business days for response to your inquiry.

To RSVP to a presentation: Select Presentation from the Inquiry Regarding drop down menu below. Please let us know how many are attending with you and the date or location of the event you plan to attend. Thank You!

CONTACT INFO

Date:    Office Name (if from a physicians office): 
Full Name: Phone Number:
 Fax Number: Email:
Inquiry Regarding: Preferred method of response contact:

Please click here to confirm that you have read and agree with the below disclaimers: (required)

Conditions of Online Contact Form:

Michigan Pain Consultants values your privacy. We have taken all reasonable precautions to ensure that your information is securely transmitted. This contact form should be used for routine purposes only, if you have an early refill or urgent need, call your offices nurses line and leave a message for the nurse to contact you back. Nurse/Refill Phone numbers:

  • Big Rapids (231) 796-5576
  • Grand Rapids (4100 Lake Drive) 616-285-1038
  • Greenville (616) 754-4357
  • Holland (616) 546-2680
  • Muskegon (231) 799-9596
  • Wyoming (2147 Health Drive) (616) 281-1700

If this is an emergency, dial 911.

These forms are downloaded on a daily basis. You can expect to get a response about  within two business days of the form being submitted.

This form is for non urgent contact only, if you need more immediate attention, have questions about your treatment or to schedule a follow up appointment you will need to call the location you are seen at to have these issues addressed. Main phone numbers below:

  • Big Rapids (231) 796-1500
  • Grand Rapids (4100 Lake Drive) 616-285-1377
  • Greenville (616) 754-5036
  • Holland (616) 546-2550
  • Muskegon (231) 799-8880
  • Wyoming (2147 Health Drive) (616) 281-1600