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HOW TO ORDER 

Downloadable pdf below:

 

Once complete, attached clinical notes, demographics, and insurance information. 

 Fax information to: 561-258-8154

Electronic Orders MUST Include:

Demographics / Insurance

Duration of Study

Diagnosis Code(s)

Previous EEG Reports (if applicable)

Clinical/Encounter Notes

Physicians Signature

Please Fax Electronically to 561.258.8154

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