For physicians

There is no special form for physicians or other licensed providers to request a neurological consultation. For routine consultation, please fax the reason for the consult; the insurance and demographics; and pertinent recent clinical notes and test results to 805-547-2228. You may call 805-547-2224 if you have any questions, need to speak with one of our physicians, or have an urgent request.

You can request neurological studies and interpretations for your patients with the forms below. Please print them out, complete them, and fax them along with your patient’s insurance information and demographics to 805-547-2228.

EMG Request Form

EEG Request Form

You, our referring physicians, are at the heart of what we do. If you are not fully satisfied with the work we have done for you, please contact Dr Filippi at 805-547-2224. We will do our best to make it right.

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