Submitting a Schedule Form

NeuroLogic strives to provide convenience in our scheduling process by offering a variety of options. You may download and fill out the scheduling form, and submit it in any of the following ways:

• Email: scheduling@neurologiciom.com
• Fax: 866-897-0799
• Phone: 877-446-4945

Information

For all options please provide the following information:

• Date of Service
• Start time of procedure
• Surgical Procedure
• Surgeon
• Patient initials

Download Scheduling Form Here

For any questions or inquiries regarding these processes please contact us at 877-446-4945.

We look forward to working with you.