One page, in English or Spanish. Four fields decide whether a referral becomes an appointment that reaches a conclusion: the clinical question, what has been examined and excluded, actual prior results rather than summaries, and the medication history with doses and reasons.
Nevada's first physician-owned outpatient EDX lab to earn it.
Founder certified in Neurology, Vascular Neurology & Neuromuscular Medicine.
Independent and physician-led since 1998 — rooted in Southern Nevada.
Partnered with the Global Alzheimer's Platform Foundation.
The referral form is a single page and is available in English and Spanish. Complete it and send it to the practice, or call 702-804-1212 if it is easier to give the details over the phone. Referrals are accepted at both offices and either can perform the full set of six in-office studies.
Both versions are one page and ask for the same four things. Either can be faxed, emailed, or brought to either office. If the form is not to hand, call 702-804-1212 and give the details over the phone.
If the form is not to hand, a letter carrying the same four things works equally well: the clinical question, what has already been examined and excluded, actual prior results, and the medication history with doses.
What you want established, not only the presenting symptom. This determines which study is appropriate and how long the appointment needs.
The work already done, including reversible causes screened — thyroid, B12, glucose, medication review.
Imaging reports and any earlier electrodiagnostic measurements, rather than a statement that they were normal.
What was tried, at what dose, for how long, and why it stopped. A drug stopped early for side effects is a candidate for retrying.
The team verifies the patient's plan participation, whether a referral requirement is satisfied, and whether any anticipated study needs prior authorisation — before the appointment rather than at reception. Where a study is likely, flagging that on the referral lets authorisation start days earlier.
Genuine urgency should be marked with the reason, so it can be triaged rather than queued. Anything sudden — sudden focal symptoms, a headache peaking within seconds, a seizure over five minutes, or a head injury with worsening drowsiness — belongs at an emergency department instead, which needs no referral and is faster than any appointment.
If you are not sure which service the question belongs to, the commonest routes are EMG and nerve conduction, EEG and headache and migraine. A full list sits on the conditions hub.
Referral content follows the reporting expectations set by the AANEM for electrodiagnostic studies and the clinical guidance of the American Academy of Neurology. Condition background for patients is available from NINDS.
Clinical Neurology Specialists performs no surgery and operates no imaging suite, infusion suite or interventional pain programme, and provides no paediatric, emergency or inpatient care.
Clinical Neurology Specialists · 7751 W. Flamingo Road, Suite A-100, Las Vegas, NV 89147 · 1691 W. Horizon Ridge Parkway, Suite 100, Henderson, NV 89012 · 702-804-1212 · Adults 18 and older.
Practical questions about the form itself.
Call the team directly and the clinical question, coverage and authorisation can be settled in one conversation.