Pediatric neurology consultation request form

Conditions

  • To ensure your request can be processed, we kindly ask you to provide a consultation request from your child’s pediatrician. Without this request, we will not be able to proceed with your application.
  • If your request is accepted, we will ask you to complete medical questionnaires and to provide the following documents via secure upload or by email (if available):
    • Health record booklet (birth data, weight, Apgar score, etc.)
    • Reports from previous assessments (speech therapy, psychological/neuropsychological evaluations, reports from other professionals, etc.)
    • School reports and report cards
    • Any relevant medical documents

Please complete this form for any pediatric neurology consultation request.

Our team will contact you as soon as possible to follow up on your request.

We sincerely thank you for your trust and remain at your disposal for any additional information.

The Pediatric Neurology Team Geneva