{"id":115,"date":"2018-10-08T15:57:55","date_gmt":"2018-10-08T15:57:55","guid":{"rendered":"https:\/\/www.beaconhealthsystem.org\/medical-professionals\/?page_id=115"},"modified":"2018-10-08T15:57:55","modified_gmt":"2018-10-08T15:57:55","slug":"neurodiagnostic-services-forms","status":"publish","type":"page","link":"https:\/\/www.beaconhealthsystem.org\/medical-professionals\/neurodiagnostic-services-forms\/","title":{"rendered":"Neurodiagnostic Services Forms"},"content":{"rendered":"<h1>Neurodiagnostic Services Forms<\/h1>\n<p>To schedule an appointment, please call Centralized Scheduling at 574.647.7700. Fax orders to 574.647.2200.<\/p>\n<p>To update any form, please download the form&#8217;s template and submit changes to Mariellan Weaver, <a href=\"&#x6d;&#x61;&#105;l&#x74;&#x6f;&#x3a;&#109;w&#x65;&#x61;&#x76;&#101;r&#x40;&#x62;&#x65;&#97;c&#x6f;&#x6e;&#x68;&#101;a&#x6c;&#x74;&#x68;&#115;y&#x73;&#x74;&#x65;&#109;&#46;&#x6f;&#x72;&#x67;.\">m&#119;&#x65;&#x61;v&#101;&#x72;&#x40;b&#101;&#97;&#x63;&#x6f;n&#104;&#x65;&#x61;l&#116;&#x68;&#x73;y&#115;&#116;&#x65;&#x6d;&#46;&#111;&#x72;&#x67;.<\/a><\/p>\n<p><a href=\"\/wp-content\/uploads\/file\/Evoked_Responses.pdf\">Evoked Responses<\/a>\u00a0(PDF)\u00a0\u2014\u00a0<a href=\"\/wp-content\/uploads\/file\/Evoked_Responses(1).doc\">Form template<\/a><\/p>\n<ul>\n<li>Ver. Ser. Baer Combination<\/li>\n<li>Visual Evoked Response<\/li>\n<li>Somatosensory Evoked Response<\/li>\n<li>Somatosensory (SER) For Surgery<\/li>\n<li>Brainstem Evoked Response\/Tympanogram<\/li>\n<\/ul>\n<p><a href=\"\/wp-content\/uploads\/file\/EEG-w-prep.pdf\" target=\"_new\">EEG &#8211; w\/prep<\/a>\u00a0(PDF)\u00a0\u2014\u00a0<a href=\"\/wp-content\/uploads\/file\/EEG-w-prep(1).doc\">Form template<\/a><\/p>\n<ul>\n<li>Electroencephalogram (90 min.)<\/li>\n<li>48 hour Ambulatory- Initial<\/li>\n<li>48 hour Ambulatory 24hr. F\/U visit<\/li>\n<li>48 hour Ambulatory 48hr. F\/U visit<\/li>\n<li>EEG video<\/li>\n<li>24 hour Ambulatory- Initial<\/li>\n<li>24 hour Ambulatory F\/U visit<\/li>\n<\/ul>\n<p><a href=\"\/wp-content\/uploads\/file\/EMG.pdf\" target=\"_new\">EMG<\/a>\u00a0(PDF)\u00a0\u2014\u00a0<a href=\"\/wp-content\/uploads\/file\/EMG(1).doc\">Form template<\/a><\/p>\n<ul>\n<li>EMG 30 min All Diagnoses<\/li>\n<li>EMG 45 min. (Except Bilat Lower Extremity)<\/li>\n<li>EMG Bilateral Lower ExtremityNerve Conduction Velocity Study<\/li>\n<\/ul>\n","protected":false},"excerpt":{"rendered":"<p>Neurodiagnostic Services Forms To schedule an appointment, please call Centralized Scheduling at 574.647.7700. Fax orders to 574.647.2200. To update any form, please download the form&#8217;s template and submit changes to Mariellan Weaver, &#x6d;w&#x65;&#97;v&#x65;&#114;&#x40;&#x62;e&#x61;&#99;o&#x6e;&#104;&#x65;&#97;l&#x74;&#104;s&#x79;&#115;&#x74;&#101;m&#x2e;&#111;&#x72;&#x67;. Evoked Responses\u00a0(PDF)\u00a0\u2014\u00a0Form template Ver. Ser. Baer Combination Visual Evoked Response Somatosensory Evoked&#8230;<\/p>\n","protected":false},"author":8,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_acf_changed":false,"ep_exclude_from_search":false,"footnotes":""},"class_list":["post-115","page","type-page","status-publish","hentry"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO Premium plugin v15.0 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.beaconhealthsystem.org\/medical-professionals\/neurodiagnostic-services-forms\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Neurodiagnostic Services Forms - Beacon Medical Professionals\" \/>\n<meta property=\"og:description\" content=\"Neurodiagnostic Services Forms To schedule an appointment, please call Centralized Scheduling at 574.647.7700. Fax orders to 574.647.2200. To update any form, please download the form&#8217;s template and submit changes to Mariellan Weaver, &#x6d;&#x77;&#x65;&#x61;&#x76;&#x65;&#x72;&#x40;&#x62;&#x65;&#x61;&#x63;&#x6f;&#x6e;&#x68;&#x65;&#x61;&#x6c;&#x74;&#x68;&#x73;&#x79;&#115;&#116;&#101;&#109;&#046;&#111;&#114;&#103;. Evoked Responses\u00a0(PDF)\u00a0\u2014\u00a0Form template Ver. Ser. 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