Refer a Patient


For Physicians

To refer a patient for neuropsychological evaluation please use the downloadable referral form and fax it to our office at 520-329-8311. Also, if you have questions about whether a neuropsychological evaluation may be beneficial to you, your patient, or their family, please feel free to contact us.

Patient Referral Form

Download Form

Please fill out the form below or download the referral form with the button above and fill it out at your convenience. Please email us if you have any questions. You can send completed paper forms to:

403 W. Cool Dr.
STE 107
Tucson, AZ 85704

or fax to:

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By clicking the submit button, you authorize the transmission of your personal health information to be sent over email. We take every effort to ensure that your information stays safe. All information is double encrypted and password protected.