Request an appointment

Appointment request form

Full name Date of birth (optional)

Phone Email (optional)

Preferred location Select one Beverly Hills (90211)Pacoima (91331)Rancho Cucamonga (91730)Santa Ana (92705)South Bay (90250)Los Angeles (90003)Los Angeles (90023) Visit type Select one New patient consultation Follow-up Test (EEG / EMG / other) Telehealth (if available) Primary concern Select one Headache / Migraine Memory / Dementia Seizures / Epilepsy Neuropathy / Numbness Dizziness / Vertigo Movement disorder (Parkinson’s) Other Insurance (optional) Message Submit request

If urgent symptoms, call 911 or go to the nearest ER.

What to bring

• Photo ID
• Insurance card (if applicable)
• Medication list
• Prior imaging/reports (MRI/CT/EEG/EMG) if available

We may request additional records depending on visit type.

Prefer texting?

Use WhatsApp for scheduling questions.

WhatsApp

Call

(310) 933-4590