Patient & Referral Forms

The following new patient forms are required forms for your first visit. Clinical Neurology Specialists has conveniently placed our office forms online for you to download and fully complete at home. Please bring the completed forms to your appointment.

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• New Patient Registration Form
• Notice of Privacy Practices and Acknowledge of Receipt Form
• Authorization to Release Medical Records Form

Billing Questions

If you think there is an error with your account or have questions about your bill, please contact us as soon as possible. We must hear from you no later than 60 days after your first bill is sent on which the error problem appeared.

You can telephone us at (702) 804-1574, but doing so will not preserve your rights. In writing, give us the following information: your name, account number, the dollar amount of the suspected error, the posting date of the transaction in question, and an explanation of why you believe there is an error. If you need more information, describe the item you are unsure about. Please be sure the person responsible for the account signs all correspondences.

Financial Options:

(click on above logo to take you directly to the application process)

(click on the above logo to take you to the Provider search screen)

• Type in Clinical Neurology Specialists in the "Does My Doctor Accept Care Credit?" search.
• Click on the "Apply Now" button next to the location you are seen.
• Complete the online application process