310-440-9800

Registration Forms

Registration Process

  1. The registration forms can all be completed online.
  2. Below you will find the link to our registration paperwork.
  3. Please read carefully and fill out each page beforeĀ  initialing at the bottom.
  4. If you have any questions, please call us at 310-440-9800 ext. 1 to speak to a CNS Specialist.
  5. Please also PRINT the completed forms and bring them with you to your appointment.
  6. When we have received your paperwork, our staff will call you to schedule an initial assessment appointment.

Registration Paperwork:

CNS Patient Enrollment Forms

 

**Please be sure to complete all pages, sign & initial where necessary, and return all paperwork 48 business hours prior to your initial appointment in order to confirm it. Please note that our re-scheduling and cancellation policy includes a necessary advanced notice of 48 business hours otherwise the regular appointment fee will be assessed.