Appointments & Contacts 408-356-0503

We have experienced and helpful front office staff to guide you through your appointment process. If you have any questions please contact us directly @ 408-356-0503.

Our Address & Contact Information:

14601 S. Bascom Suite #240
Los Gatos, CA 95032
Phone: (408) 356-0503
Fax: (408) 356-4704

Page Resources:

Pain Management Physicians of Silicon Valley San Jose South Bay Area California Pain Injections Spine Treatments Detailed Map & Directions
Pain Management Physicians of Silicon Valley San Jose South Bay Area California Pain Injections Spine Treatments Preparation for your visit
Pain Management Physicians of Silicon Valley San Jose South Bay Area California Pain Injections Spine Treatments Patient forms- Welcome Pack
Pain Management Physicians of Silicon Valley San Jose South Bay Area California Pain Injections Spine Treatments New Patient Information
Pain Management Physicians of Silicon Valley San Jose South Bay Area California Pain Injections Spine Treatments Office Policies
Pain Management Physicians of Silicon Valley San Jose South Bay Area California Pain Injections Spine Treatments Notice of Privacy Practices
Pain Management Physicians of Silicon Valley San Jose South Bay Area California Pain Injections Spine Treatments Referral Information & Form


Pain Injections Spinal Cord Stimulation Clinical Trials Doctor Silicon Valley San Jose California Good Samaritan Chakerian MD
Preparation For Your Appointment - What to bring

We want to answer as many of your questions at your visit.

Please prepare for this by bringing:

Pain Management Physicians of Silicon Valley San Jose South Bay Area California Pain Injections Spine Treatments Health Insurance Card/Information
Pain Management Physicians of Silicon Valley San Jose South Bay Area California Pain Injections Spine Treatments A friend or family member to take notes/help with questions
Pain Management Physicians of Silicon Valley San Jose South Bay Area California Pain Injections Spine Treatments A list of all medications you are taking
Pain Management Physicians of Silicon Valley San Jose South Bay Area California Pain Injections Spine Treatments A list of your questions /concerns
Pain Management Physicians of Silicon Valley San Jose South Bay Area California Pain Injections Spine Treatments A copy of your XRAYS / CT scans (not the reports - get the actual films)
Pain Management Physicians of Silicon Valley San Jose South Bay Area California Pain Injections Spine Treatments Copies of records from doctors related to your condition
Pain Management Physicians of Silicon Valley San Jose South Bay Area California Pain Injections Spine Treatments Completed FORMS


Pain Injections Spinal Cord Stimulation Clinical Trials Doctor Silicon Valley San Jose California Good Samaritan Chakerian MD
Office Policies

  • Please remember to bring all forms, completed, to your first appointment. Otherwise, your appointment will be rescheduled and you may be charged for the appointment.
  • If you are more than fifteen minutes late for your appointment, we will need to reschedule and a fee will be charged.
  • If you need to cancel an appointment, we require 24 hour notice. If we do not receive either a call or a message 24 hours prior to your appointment, there will be a $100 fee charged to you. Voicemail may be left after office hours. Fees must be paid before another appointment may be scheduled.
  • There is a $25 per page fee for all disability forms and/or letters. Payment will be collected at the time forms/letters are requested.


Pain Injections Spinal Cord Stimulation Clinical Trials Doctor Silicon Valley San Jose California Good Samaritan Chakerian MD
Patient Forms

Forms available for download

Forms require free Adobe Reader. Download here if necessary.


Pain Injections Spinal Cord Stimulation Clinical Trials Doctor Silicon Valley San Jose California Good Samaritan Chakerian MD
New Patient Information

Dr. Chakerian sees new patients by referral only.  Referral may come from your primary care doctor or specialist treating you.  Once we receive a referral from your doctor, we will request copies of all of the medical records pertaining to the problem for which you are seeking treatment.  Dr. Chakerian reviews all of this material in order to determine if she can help you.  Until Dr. Chakerian has all of your records, this decision cannot be made.  You may be able to speed up the process by making the request to have your doctor release your records to Dr. Chakerian, and signing a “Release of Medical Information” consent form.

Dr. Chakerian has a policy regarding the prescribing of controlled substances, and every patient who receives a prescription for controlled substances needs to read and sign an agreement regarding these medications.  The agreement can be viewed in the Patient Welcome Pack.  Not all patients are candidates for this type of medication, and not all patients will benefit by this type of medication.  In addition, there are instances where people abuse, divert, or become addicted to certain controlled medications.  In order to protect your health and Dr. Chakerian’s prescribing ability, patients are monitored very closely for possible addiction, abuse, and diversion.  This monitoring may include frequent follow-up office visits, urine drug screens, and the sharing of medical records between your physicians and your pharmacies.  You should not expect to receive a prescription for a controlled substance at your first visit, and Dr. Chakerian may not take over the prescribing of controlled substances from other doctors.


Pain Injections Spinal Cord Stimulation Clinical Trials Doctor Silicon Valley San Jose California Good Samaritan Chakerian MD
Dear Referring Physician,

Please download and complete the following referral form and fax over the patient's

  • Demographics
  • Insurance card
  • Pertinent diagnostic studies
  • Physician referral form

Referral Form

FAX To: 408-356-4704

Once we have received these documents, the records will be reviewed, your patient will be contacted.

For questions please contact us @ 408-356-0503

Thank you for your referral!

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