EEG Referrals for Physicians

Referring clinicians can use the form below to request EEG monitoring. Our team can discuss routine, prolonged and ambulatory EEG, including paediatric testing, subject to clinical suitability and local availability.

For genetic testing, we coordinate access to selected tests through a laboratory partner. Read about genetic testing or contact our team to discuss the referral process and a suitable way to transfer clinical information securely.

Patients and families seeking general information should use our patient enquiry form. Please do not include confidential medical details in general enquiries.

 

request EEG

Please fully complete the form below and we will be in touch shortly.

EEG Request

EEG Options

Patient Information

Address
Address
City
State/Province/Parish/Region
Zip/Postal
Country
Gender

Referring Physician

Address
Address
City
State/Province/Parish/Region
Zip/Postal
Country
I certify to the best of my knowledge that this test and any interpretation is medically necessary in order to diagnose my patient. I understand that this test and any interpretation provided are intended only to supplement my diagnosis of this patient’s condition. I recognize that Nyota-Tano Diagnostics will not provide a diagnosis of this patient nor will Nyota-Tano Diagnostics Ltd. recommend any therapeutic measures for this patient.
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