Precision Neurobiology™

Case Review Intake

Complete this intake before payment so the case review can be scheduled appropriately and prepared in a structured way.

Precision Neurobiology Case Review

$395

Includes pre-review of submitted information, a focused 30-minute live session, and a written Precision Neurobiology report delivered by email.

Parent or guardian information

Parent / guardian name *

Email address *

Phone number

State where you are located *

Child information

Child name *

Child age *

Case background

Brief summary of the case *

What are you hoping to gain from the Case Review? *

I have prior records, labs, genetic reports, imaging, qEEG reports, or other supporting documents available to submit.

Required acknowledgments

I confirm that I have already completed Precision Screening. *I understand that Precision Neurobiology Case Review is an educational and interpretive service. *I understand that this is not a medical evaluation, diagnosis, treatment service, psychotherapy service, or emergency service. *I understand that this service is not billed to insurance and no clinically coded receipt or superbill will be provided. *I understand that any clinical, medical, or treatment decisions should be reviewed with the child’s licensed local providers. *I confirm that the information I provide is accurate to the best of my knowledge. *