To request a neurologic consultation for your patient please fill out the form below. Upload the patient's medical records, recent blood work and radiographs to the appropriate sections on this form. Send any additional information, or files too large to upload, to

Consultation Request
CBC & Chemistry Completed*
Upload Medical Records Here
Upload Additional Records Here
Chest Rads Completed
Upload X-ray Here
Upload Additional X-ray Here

Thank you for requesting a consultation for your patient with the VSCAN!