Refer a Patient for EEG, Evoked Potential, Ultrasound, Doppler Test

To request an EEG, Evoked Potential, Ultrasound, or Doppler Test, please download or complete the form below, noting the type of test requested. This form gives us valuable information regarding your patient's history and symptoms. However, it is still necessary for you or your patient to call to schedule an appointment.

Online Request:
Refer a Patient to Noran Neurological Clinic

Downloadable Form:
MDC Patient Referral Form (558 KB PDF)

Make an Appointment:
Direct: 612.879.1549
In-state: 800.489.2719
Toll-free: 800.328.9713

Fax: 612.879.0913

Thank you for your referral. At Minnesota Diagnostic Center, we are committed to providing patients with the highest quality care.

Viewing Forms

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