(954) 344-9772
(954) 227-0551
brainhealingcenter@gmail.com


My First Appointment

My First Appointment


Welcome to your first appointment!

Here you will get the items needed to begin your healing process with us.

Below is the information that you will need.

Please read carefully because it is important that you get the correct items to meet your individual needs.

Paul Wand M.D.

If your needs are for:

  • Neurological Consultation (e.g. brain injury, ASD, cerebral palsy, seizure disorder, etc.)
  • Allergy or Blood tests
  • MRI, CAT Scan, SPECT Scan
  • EEG
  • Pain Management/ Numbness & Tingling
  • Supplements

Congratulations! Your first appointment is with Dr. Wand.

Please download the forms below and bring them with you to your first appointment. You may also fill them out at the office if so; please arrive at least 30 minutes before your scheduled time.

New Patient Information Package for:
Pain Management/ Personal Injury / Workers Comp patients
Hormone Replacement Therapy patients
Autism Spectrum Disorder
Privacy/HIPPA Law
 

Gerald Gluck Ph.D, LMFT, Senior Fellow 2, BCN

If your needs are for:

  • Individual Counseling (ASD, addictions, personal growth, depression, problems at school/work etc.)
  • Family Counseling (divorce, better understand your kids, etc.)
  • Marriage Counseling (intimacy, constant arguing, aligning your goals, communication etc.)
  • Neurofeedback/Biofeedback (ASD, C.P., Seizures, Headaches, ADD/ADHD, improve academic performance etc.)
  • Behavior Management Skills
  • QEEG 

Congratulations! Your first appointment is with Dr. Gluck.

Please download the forms below and bring them with you to your first appointment. You may also fill them out at the office, if so please arrive at least 30 minutes before your scheduled time AND inform us prior to your arrival.
   INTAKE FORMS
>Children (all patients age 15 and under)
>Adolescents (all patients ages16 to 17)
>Adults (all patients age 18 and up)
>Autism Spectrum Disorder (any age patient living with ASD)

INTAKE CONSENT FORM

Informed Consent And Financial   Policy Form (all patients)    

 

QEEG FORMS (DOWNLOAD ALL 3)
1. 
QEEG Intake and Consent (When you are scheduled  this service)

2. QEEG SYMPTOM CHECKLIST (When you are scheduled for this service.)

 

3. Instructions for Preparing for a QEEG (When you are scheduled for this service)


>Consent for Neurofeedback Training (only if you are scheduled for this service)

>INFORMED CONSENT FOR LORETA NEUROFEEDBACK


>Privacy/HIPPA Law (all patients)


       

INTAKE CHECKLISTS

>Self Rating Check List for Adults

Symptom Checklist for Children

 


Special Notice

Feel free to contact us by phone or email with any questions you may have.
(954) 344-9772
(954) 227-0551
brainhealingcenter@gmail.com

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Neurofeedback, attention deficit disorder, ADD, ADHD,hyperactivity, Aspergers, autism, depression, anxiety, DAN doctor, Neurology, LORETA