Refer a Patient: Epilepsy Center

When submitting a referral, please include:

• The reason for the referral
• Whether you're requesting a clinic evaluation or admission to the inpatient video EEG monitoring unit
• All pertinent recent clinical information, including results of EEG, MRI and other imaging, if available

Reasons for referrals (examples)

This list is by no means complete. There are other possible reasons.

• Consultation regarding diagnosis of seizure when questions are present
• Second opinions
• Refractory epilepsy

Patients may be referred for direct admission to inpatient video EEG monitoring if they:

• Require diagnostic seizure monitoring for characterization and localization of spells or seizures
• Require extended diagnostic testing for known epilepsy
• May be candidates for epilepsy surgery

Here's how to refer a patient who resides in the United States.

Please note that your patient can schedule an appointment with us before the referral process is complete. Ask your patient to call the clinic, and we'll get things started.

Option 1: Refer online

Complete and submit this form, which auto-fills some fields after selecting the referring provider.

Online referral form

Option 2: Refer by fax

Download our referral form as a PDF, complete it, and fax it to us at the number above.

Universal referral form

Option 3: Refer through MD Link

Use MD Link, a secure portal that allows you to easily refer patients to UCSF Health and stay connected to their care.

Log into MD Link account

More about MD Link

If you need assistance with a referral or have other questions, please call (415) 353-2134.