Brain Health

Referral Form for my Doctor

Routine and Ambulatory EEG with Video Monitoring

What can cause
a Seizure?

Anything that interrupts the normal connections between
nerve cells in the brain can cause a seizure.

What are Seizures?

Cognitive or emotional symptoms, loss of consciousness or awareness, temporary confusion, uncontrollable jerking movements of the arms and legs.

What is an 
electroencephalogram (EEG) study ?

It records electrical activity in your brain using
electrodes attached to your scalp.

What equipment is used?

  • Data Recorder
    • Usually battery powered and mobile, records all brain activity
  • Video Recorder (if ordered)
    • Will record all movements while you are awake or asleep
  • Echocardiogram (ECG) patches
    • Added to your upper chest area for heart monitoring.

Frequently Asked Questions

During testing, your doctor may want our staff to remotely review the data in real time. If this is requested by your doctor, the technologist will give you more details at the time of your setup appointment.

Arrive with clean dry hair. Do not add any hair products. Wear a loose fitting shirt that zips or buttons in the front. You may bring a loose hat or scarf towear home. DO NOT change or stop any of your medications unless instructed to do so by your doctor. Plan to arrive to the office 15 minutes prior to your appointment time.

The technologist will explain the complete testing process and answer any questions you may have. The technologist will place 25 electrodes on your scalp. Echocardiogram (ECG) patches will be added to your upper chest area for heart monitoring.The entire setup process is painless and will take about one hour.

During the test you will be able to walk around freely. Most patients choose to stay home during testing due to the electrodes and headwrap. Patients undergoing monitoring are strongly encouraged to remain at home during the entire testing period. Data recording may face interference from other devices and can compromise testing. Your doctor may have specific suggestions for you. You will wear the recording device at all times. This includes while awake, asleep, eating, watching TV, reading, and moving. Please do not attempt to remove the electrodes or patches. Avoid all heavy activities or exercise. Sweating interferes with testing and may require the test to be repeated. It is important that both you and the equipment stay dry at all times. This means NO showers, baths, or being outside in the rain during testing.

Video, when recorded with EEG, provides key details for your doctor. Small changes that are recorded on video may help your doctor with the findings and treatment, which could give you better results. You can help in this process by having the video recorder positioned so your face is visible as much as possible.

At the end of your study, you will return to the same location to have your study ended. The electrodes and recording devices will be removed. Your head will be cleaned and the study results will be sent to your doctor. Bring your completed Log Sheets and provide them to the EEG Technologist.


Let's connect.

Please do not use this form to cancel sleep or EEG appointments, or to request information regarding appointments. For specific questions about your study or test, please refer to the confirmation email or patient packet sent to you.

Requests for home sleep test results should be directed to your ordering provider 7 days after the completion of your home sleep test.

For all other inquiries, please fill out the form below or give us a call at (800) 753-3763.