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Henderson
9029 S Pecos Ste 2800
Henderson, NV 89074

Las Vegas
630 S Rancho Ste H
Las Vegas, NV 89106

Phone: 702.739.8323
Fax: 702.739.8605


FMLA

To request an FMLA, please download and fill out the form above.

Please note, there is a $25 fee for each FMLA form.
No FMLA requests can be released until fees are paid.

You can fax your FMLA request AND Credit Card Authorizations to:
Fax: 702-739-8605
or 
Email to: info@paindoclv.com

For more information or to schedule a consultation, please contact us today.
Call 702.739.8323 or send us a message on the Contact Us page. Hablamos Espanol
FMLA FORM
CREDIT CARD 
AUTHORIZATION
ADVANCED  PAIN  MANAGEMENT   CENTER  -   
SATISH SHARMA, MD & Kunal Parikh, MD