Phone (713) 863-7246 | Monday to Friday 7am-5pm | Fax (713) 863-9524

Patient Area

Save time. Be prepared. Print and fillout all your paperwork before your appointment.

Patient Paperwork

Thank you for choosing Pain Relief Associates for your care. To make an appointment or for more information please contact our office directly by completing our Contact Form or calling (713) 863-9524.

All new patients will need to fill out these General Forms. If you are already a patient or if you will be visiting more than one of our 5 offices, note, the General Forms will only need to be filled out once and delivered to your first office visit. Thank you for helping us serve you.

Pain Management

Dr. Chin (Please fill out all three)

Accepted Insurances

Managed Care Plans
  • Aetna (EPO, HMO, POS, PPO)
  • Aetna Signature Administration
  • Amerihealth
  • Association & Society Insurance (ASI)
  • Blue Cross Blue Shield (EPO, HMO, POS, PPO)
  • Blue Cross Blue Shield Marketplace
  • Boon Chapman
  • Celtic
  • Champva
  • Christian Fidelity Life Insurance
  • Cigna (EPO, HMO, POS, PPO)
  • Community Health Choice Marketplace
  • Conventry/Texas Advantra
  • ELCA
  • Freentree Administrators
  • Freedom Life Insurance
  • Government Employee Health Association (GEHA)
  • Genworth
  • Group Benefits Services
  • Group Pension Admin
  • Health Design Plus
  • Health Smart Benefit Solution
  • Humana
  • Humana Tricare
  • Kelsey Care Advantage
  • Loyal
  • Mail Handlers Benefit Plan (MHBP)
  • Manhattan Life Insurance Company
  • Meritian
  • Memorial Hermann Health
  • Multiplan
  • Mutual Omaha
  • New Era Life Insurance
  • Office of Group Benefit
  • Old Surety
  • Private HealthCare System (PHCS)
  • Physicians Mutual
  • Regency Employee Benefits/Global Care
  • Reserve National
  • United Medical Resources (UMR)
  • United Health Care (EPO, HMO, POS, PPO)
  • Universal
  • Veteran Choice Program
  • Washing Nation Life Insurance
Medicare Advantage / Replacement Plans
  • Amerivantage/Medicare Advantage
  • Medicare (All PPO)
  • Medicare HMO (Aetna, BCBS, HUMANA, UHC)
  • Traditional Medicare