Neurological Associates of St. Paul, P.A.

Request Appointment

To make an appointment with one of our physicians call our office (651)221-9051. You can also request appointment online by submitting the form below. After you submit the request, our scheduling department will contact you within one business day with details of your appointment. In order to expedite scheduling, please fill out all fields.

Please note that this form is only intended to help you schedule an appointment with our physicians. For patient care related questions call our office 651-221-9051 or sign up for our HIPPA compliant patient portal to securely communicate electronically with your physician. Call our office if you are interested in signing up for the patient portal. Thank you.

Last Name

First Name:

Middle Initial

Date of Birth (MM/DD/YYYY)




ZIP Code

Home Phone

Business Phone

Cell Phone

Email Address

Preferred Contact Method

Referring Physician

Reason for Appointment
Choose Your Preferred Provider

New or Established Patient

Health Insurance

Preferred Day for Appointment

Preferred time for Appointment

Preferred Location