For Physicians

For your convenience, you will be able to download and print the below referral form and fax it to our office. We will call the patient within 24 hours and schedule them for the soonest appointment. Same day/week appointments are always available if requested by referring providers.

We strive to make this process as easy and streamlined as possible for the referring provider and patient's families. Providers can also fill out and submit the form seen on the right and Dr. Varghese will return the message or call back as soon as possible.  


PDF | The Houston Institute of Neurology for Kids

Patient Referral

Referral form for a new patient coming from another physician

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