Request Medical Evaluation
Submit your information and medical records for clinical review by the CIREN specialist team.
Documents for Review
To help the CIREN specialist team assess your case, please provide as many of the following as possible.
Neurological Medical Summary
RequiredA recent letter or report from your treating neurologist describing your diagnosis, clinical history, and current condition.
Recent Neuroimaging (MRI / CT)
RequiredMRI or CT scan reports from the last 12 months. Include the imaging on CD/DVD or DICOM files if available — not only the written report.
Neurophysiology Reports
RecommendedEEG, EMG, nerve conduction, or evoked potential studies. Required for epilepsy, ALS, and peripheral nerve cases; recommended for others.
Neuropsychological / Cognitive Assessment
RecommendedCognitive evaluation reports (e.g. MMSE, MoCA, or full neuropsychological testing). Required for Alzheimer's, dementia, and TBI cases.
Laboratory Test Results
RecommendedRecent blood work and, where relevant, cerebrospinal fluid analysis or metabolic/genetic panels.
Current Medication List
RequiredA complete list of all current medications with dosages and schedules, plus any prior treatments tried and their outcomes.
Prior Treatment & Rehabilitation Records
RecommendedRecords of previous rehabilitation programs, surgeries (including neurosurgery), botulinum toxin, or therapies related to your condition.
Surgical / Operative Reports
RecommendedIf you have had neurosurgery, include the operative report and any implanted device details (e.g. DBS settings).
Identification Document
RequiredA clear copy of your passport (photo page) for international patient identification.
All uploaded files are stored privately and securely. Only the CIREN medical review team can access them.