Refer a Patient to Noran Clinic

To request a consultation from one of the neurologists at Noran Clinic, please download and fill out the Request for Consultation Form below. 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 612.879.1500 or 800.489.2719 to schedule an appointment.

If you would like the patient to see a specific neurologist, please indicate that on the form and to our scheduling staff so that we can best meet your needs. If you have any special instructions for your patient's visit to Noran Clinic, please ask to speak with the neurologist's nurse or secretary.

For neuropsychological testing, please send or fax pertinent records, such as recent office notes or diagnostic testing in relation to condition being seen for, to 612-879-1527 within one week of scheduling.

Online Request:
Request for Consultation or EMG Referral

Downloadable Form:
Request for Consultation Form, Consult or EMG Referral (335 KB PDF)

Make an Appointment:
Direct: 612.879.1500
Toll-free: 800.489.2719

Fax: 612.879.9116

Thank you for your referral. At Noran Clinic, we are committed to providing patients with the highest quality of care.

Viewing Forms

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