New Patient Supporting Documents for the Neurology Department

Looking for Referral Guidelines? Download them here.

Pediatric Neurology/Neuropsychology Diagnosis /Symptom: Abnormal or Involuntary Movement

What should the referring provider send?

1. A complete list of all medications used to treat abnormal/involuntary movements
   along with a list of other medications currently taken.
2. Relevant medical records, including:
   Copies of relevant official reports of studies,
   Copies of brain-imaging studies completed
   (please send images on optical media)

Pediatric Neurology/Neuropsychology Diagnosis Symptom: Developmental Delay/Regression

What should the referring provider send?

1. Growth charts
2. Results of developmental screening tools
3. Early intervention and therapy reports
4. Newborn screening results
5. Any medical information about other family members with developmental concerns
6. Results of vision, hearing screenings

Pediatric Neurology/Neuropsychology Diagnosis /Symptom: Episodic Loss of Consciousness

What should the referring provider send?

1. Copies of all medical records pertaining to the incidents including:
   ED reports
   Laboratory studies
2. Copies of imaging or EEG’s previously obtained should be sent on optical media with the patient.

Pediatric Neurology/Neuropsychology Diagnosis /Symptom: Febrile Seizure

What should the referring provider send?

1. Relevant medical records
2. Copies of official reports of brain-imaging studies, if obtained. (Brain imaging and EEG should be deferred unless recommended by the neurologist.)
   (Please send images on optical media.)

Pediatric Neurology/Neuropsychology Diagnosis /Symptom: First Unprovoked Seizure

What should the referring provider send?

1. All relevant medical records
2. Awake and asleep EEG (send on optical media if study not performed at Children’s Colorado).
3. Copies of all the official reports of ancillary studies and all brain imaging studies on optical media.
4. A home video and calendar or log of seizures/spells are helpful.

Pediatric Neurology Diagnosis /Symptom: Headache

What can referring provider send?

1. A complete list of all medications used to treat headache (both acutely or for prophylaxis) along with a list of other medications taken
2. Medical records regarding relevant past evaluation and treatment of headaches
3. Any brain imaging films
4. EEG reports and
5. Relevant laboratory reports
6. Parent’s written headache calendar indicating:
   Date and time of day of each headache,
   Duration of each attack
   The severity and description of the attack
   The treatment provided and response
   Any causative factors (e.g. foods, activities, stressors).