Documents for Download
A list of documents related to NeuroDevelopment Center services is given below. Click on the title to download the document in PDF format.
These documents require the free Adobe Acrobat reader. If you don't have this installed already, it's a free download from Adobe's Website.)
PATEINT REGISTRATION
New patient registration documents. Please print and fill out these documents completely and either fax them to the NeuroDevelopment Center at 401 351-8188 or bring them for your first appointment.
NEUROFEEDBACK DOCUMENTS
Insurance coverage information worksheet. Print and complete this worksheet to obtain a record of information concerning your insurance coverage for QEEG and neurofeedback.
QEEG preparation checklist. Please print and complete this checklist prior to coming for your qEEG appointment. At the Center, give it to the technician who is doing the recording. It is critically important that you follow all of these steps prior to your qEEG to assure a good quality recording.
QEEG Social Story. If your child has an autism spectrum disorder (Autism, Asperger's Disorder, PDD-NOS) you may want to help him or her to prepare for the QEEG recording. Social stories are often useful to help kids with ASD understand a difficult or confusing situation. The kids usually feel much more comfortable with a new experience if they can make a visual map of the experience in advance. It helps them to know what to expect so that they do not get surprised. We have written a social story to help you prepare your child for their QEEG recording. You may want to read it to them several times before they come to our center for the recording.
Parent Checklist for neurofeedback with children and adolescents. Please print and complete this questionnaire and bring it with you for your qEEG appointment.
Self report checklist for neurofeedback with adults. Please print and complete this questionnaire and bring it with you for your qEEG appointment.
PSYCHOLOGICAL AND NEUROPSYCHOLOGICAL TESTING DOCUMENTS
Child Neuropsychological History for evaluations with Dr. Vandergrift or Dr. Napolitano. Please print and complete this questionnaire and bring it with you for your appointment with Drs. Vandergrift or Napolitano.
Parent Checklist for evaluations with Dr. Vandergrift or Dr. Napolitano. Please print and complete this questionnaire and bring it with you for your appointment with Drs. Vandergrift or Napolitano.
Teacher checklist for evaluations of children and adolescents with Dr. Vandergrift or Dr. Napolitano. Please print and complete this questionnaire and bring it with you for your appointment with Drs. Vandergrift or Napolitano.
Self report checklist for evaluations of adults with Dr. Vandergrift or Dr. Napolitano. Please print and complete this questionnaire and bring it with you for your appointment with Drs. Vandergrift or Napolitano.
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