Below is a list of items we require prior to your initial appointment. Please send the below items to vdiaz@neurovationsclinic.com
1. Copy of referral given to you by your referring physician if applicable
2 Copy of insurance and ID card
3 Any medical records from your PCP, other specialist or hospital visits that are pertinent to your neurology visit
4 Prior diagnostic test reports such as CT, MRI, EEG (brain wave test), EMG/NCV (nerve conduction test). Actual CD's of images are not required.
2200 Lee Road, Winter Park, Florida 32789, United States
Phone: 321-285-2369 Fax: 407-975-1247
Monday - Thursday: 9AM–4PM
Friday - Sunday: closed
Please print all 4 Sections
Sections:
1. Patient History Form
2. Patient Registration Form
3. Patient HIPAA form
4 Office Financial Policy form
Neurovations Clinic
2200 Lee Rd , Winter Park, Florida 32789, United States
Ph 321-285-2369/Fax 407-975-1247
Copyright © 2023 Neurovations Clinic - All Rights Reserved.