Neuroscience at The Queen’s Medical Center – West O‘ahu

Referral Forms

Thank you for your referral to the Queen’s Neuroscience Institute at The Queen’s Medical Center – West O‘ahu. We look forward to providing the best neurological care for your patients.

To Make a Referral

1. Complete our referral form:
   • Download Neuroscience Clinic Form
   • Download Neurodiagnostics Referral Form
2. Attach supporting patient notes
3. Fax all documents to 808-691-3347

If imaging was performed outside of Queen’s, please have any images specific to the issue sent to the Neuroscience Clinic at Queen’s – West O‘ahu prior to appointment, or have the patient bring them on a CD at the time of consultation.

Call us at 808-691-3135 for any additional questions.