Monday: 8:00 am - 4:30 pm
Tuesday: 8:00 am - 4:30 pm
Wednesday: 8:00 am - 4:30 pm
Thursday: 8:00 am - 4:30 pm
Friday: 8:00 am - 4:30 pm
|Reason for Visit||Type of Visit||Additional Info|
|Neuropsychological evaluation of memory and other cognitive complaints, dementia evaluation, capacity evaluations||Telehealth, in-person|
Please include demographic information, insurance information, and whether a prior authorization has been obtained. Also include the provider's progress note detailing the reason for referral. Indicate in the referral if it is time sensitive. If a family member or caregiver usually schedules for the patient, please include their contact information.