Patient Forms, Map, and Directions to Fairlawn Office
Your first visit to {Selson Clinics Neurology} establishes a vital foundation for our relationship with you. During your first visit, we make sure to obtain important background information about your medical history and give you time to get to know the neurologist.
Please read through this to understand what to expect for your first visit to our practice. You will find all the practical information.
Mission Statement
Our practice is working together to realize a shared vision of uncompromising excellence in neurologic care.
To fulfill this mission, we are committed to:
- Listening to those we are privileged to serve.
- Earn the trust and respect of patients, professionals, and the community.
- Exceed your expectations.
- Ensure a creative, challenging, and compassionate professional environment.
- Strive for continuous improvement at all levels.
Patient Forms
Please print and fill out these forms so we can expedite your first visit:
- Initial Neuro Evaluation [PDF] [Online]
- Follow-Up Neuro Evaluation [PDF] [Online]
- Post-Hospital Neuro Evaluation [PDF] [Online]
- Contract for Narcotic/OPIOID Maintenance Therapy [PDF] [Online]
- Contract for Stimulant Maintenance Therapy [PDF] [Online]
To view or print these forms you will need Adobe Acrobat Reader installed. Click here to download it: 
What To Expect
Being well-prepared for your appointment will ensure that the doctor has all of the needed information to provide the best possible care for you. It also will help relieve any unnecessary anxiety you may be feeling. Educate yourself on your symptoms by reviewing the content on this website. Also, take some time to review our staff page and familiarize yourself with the doctor. We look forward to your first visit.
We also use UPDOX to communicate with patients
- SMS & Secure Text
- Two-way secure text messaging (MMS)
- Video Chat-Telemedicine (Virtual neurological evaluation
- Broadcast Messaging
- Messaging to groups of patients
- Human voice phone messages
- Schedule appointments
- Customizable Reminders
- Appointment Reminders
VIRTUAL NEUROLOGICAL EVALUATION (VNE)
PURPOSE
Visual Neurological Evaluation (VNE) is a component of Telemedicine and is used to allow patients to be neurologically monitored comfortably and effectively, and to use this exchange of medical information via electronic communications to improve patient health. This will allow patients to be evaluated at home or work.