Provider Resources

Providers may refer patients to any of our multidisciplinary specialty clinics:

• ALS
• Parkinson’s disease and movement disorders
• Multiple Sclerosis
• Peripheral Neuropathy
• and Multidisciplinary Specialty Clinic-Therapy Only

or to our physician-only clinics:

• Epilepsy
• Physical Medicine and Rehabilitation
• Stroke

by completing and faxing the Physician Referral & Order Form to (602) 839-2522.

Please include patient’s demographic information, insurance information, insurance authorization (if required) and any pertinent medical records. 

Once the referral is received, we will contact the patient and set up the appointment. 

We appreciate your referral and are committed to providing the highest quality, comprehensive care for your patients.

For patients requiring Tysabri or IGg infusions, please contact our Infusion Clinic by calling (602) 839-4205.

You may contact us using any of the methods listed below.  We are happy to answer any questions or concerns related to the Neuroscience Clinic.

• Email
• Phone: (602) 839-6533
• Fax: (602) 839-2522

Mailing Address:
Neuroscience Clinics
Banner Good Samaritan Medical Center
1012 E. Willetta St., Suite 54
Phoenix, AZ 85006