Step 1: Request a Referral From Your Physician

Your primary care doctor, or a specialist such as a rheumatologist, must send us the following documents before we can schedule an appointment:

  • A referral (whether or not it is a requirement by your health insurance)
  • Patient demographic sheet to include insurance information
  • Copies of your 3 most recent office visits to your primary care provider
  • Current medication list
  • Labs and x-rays
    • Labs include a CBC, CMP, ANA, CRP, ESR, TSH, T3, T4, and Vitamin D.
    • If you do not have these lab results available, we may request you to complete them after your first visit with the physician.

Step 2: Confirm Your Insurance Coverage

We encourage you to contact your insurance company regarding your coverage.
The codes you will need when you contact your insurance are:

  • Trigger point Injections (20553) for Fibromyalgia (M79.7)
  • Spinal manipulations (98927) for Fibromyalgia (M79.7)

Questions to ask your insurance company:

  1. Is Dr. Ashley Keays considered a preferred provider with my plan?
  2. Do I need to have a prior authorization for any of the above services?
  3. Is there a limit to the number of services I may have in one year; i.e. does my insurance limit the number of trigger point injections or manipulations?

Every insurance plan is different, so we ask patients to be responsible for keeping track of their benefits and how many manipulations and trigger point injections they have had and how many they are allowed.

Step 3: Schedule Your Appointments

Please feel free to contact our office to confirm your physician has sent over the necessary medical records and referral. Once we have evaluated the records, we can schedule your series of 12 appointments.

Step 4: Complete the Patient Intake Form

We complete a thorough initial evaluation to confirm your diagnosis and develop a personalized care plan for you. This requires an in-depth intake process. Once your appointments have been scheduled, please complete the Patient Intake* form. This is in-depth documentation of your health history and can take some time to complete. You do NOT have to complete it in one sitting. You may save the form to your computer and return to it at any time. Once completed, please attach and submit your intake via email to:

When your appointments are scheduled, we will provide a due date for the intake form. If the intake form is not returned by the agreed upon due date, we will not have the information needed for a successful, effective first visit, and your appointments will be cancelled.

*Microsoft Word Format – If you require the PDF version, click here. (Adobe X or newer)