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Patient Information





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Insurance Information






Order Information


  • 95700 - EEG hookup
 







  • No ECG






Patient history and previous EEG results are required for preauthorization. Please upload below to avoid delays in scheduling. We accept PNG, JPG, PDF, TIFF, and Microsoft Word files. Max size: 12MB


Physician Reports/Interpretation





  • By checking the box, you are indicating that you are the referring physician and are authorizing the EEG study for this patient.