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Referral Fax Form Muhammad Muir, M.D. Phillip Ham, D.O. 7760 W. VOA Park Drive Suite D West Chester, Ohio 45069Phone:5138600371 Fax:5138601710Patient Information Name: DOB: Address: Home phone: Alternative
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Who needs adult neuropsychological intake exam?

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Adult neuropsychological intake exam is typically needed by individuals who:
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- Have experienced brain trauma or injury, such as a concussion
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- Show signs or symptoms of cognitive impairment, memory loss, or attention problems
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- Have been diagnosed with a neurological or neuropsychiatric disorder, such as Alzheimer's disease, Parkinson's disease, or ADHD
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- Require evaluation and assessment of their cognitive abilities for diagnostic or treatment purposes
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- Need baseline cognitive testing for comparison in the future, such as athletes or individuals in high-risk occupations
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An adult neuropsychological intake exam is a comprehensive assessment that evaluates cognitive functions, emotional status, and behavioral issues in adults, typically conducted by a neuropsychologist to understand brain-behavior relationships.
Individuals seeking evaluation for cognitive or psychological concerns, as recommended by healthcare professionals, are required to undergo an adult neuropsychological intake exam.
The adult neuropsychological intake exam is typically completed with the assistance of a trained professional. It involves answering detailed questions about medical history, cognitive functioning, and behavioral issues.
The purpose of the adult neuropsychological intake exam is to diagnose cognitive impairments, assess the impact of neurological conditions, and help develop treatment plans for individuals with cognitive or psychological disorders.
The intake exam must report information such as the patient's medical history, current symptoms, previous cognitive assessments, medications, and family history of neurological or psychological conditions.
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