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Provider Patient Referral form

To refer a patient to BrainHealth, please download the appropriate referral form and fax to 1-877-766-3950 or upload here.

BrainHealth provides actionable science-based programs and feedback for those at risk or in the early stages of cognitive impairment. We offer:

  • Cognitive Testing and Care Planning
  • APOE Genotyping
  • Lifestyle Program Membership
  • Lab Testing