Doctor Referral Form
Patient Referral — DBS Evaluation
Dear colleague, please share the full clinical picture of the patient you wish to refer. Our team will review your referral and reach out to you.
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Referring Doctor
Please provide your information so we can get in touch.
Dr.
Prof.
Prof. Dr.
MD
PhD
Other
Neurologist
Movement Disorders Specialist
Neurosurgeon
Primary Care
Psychiatrist
Other
WhatsApp
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Ready to discuss your case?
Send your reports before travelling to Istanbul
Share your MRI, medical reports and symptom videos on WhatsApp. Our team will review your information and guide you on whether an in-person DBS evaluation may be appropriate.
Start with a remote case review.