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Concussion and Brain Injury Clinic

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Appointment Request Screening

To confirm: The injury was less than two weeks ago.

NEXT QUESTION: Does the patient have ANY of the following symptoms?

· Is the patient confused, lethargic, or disoriented?

·  Does the patient have a severe headache?

·  Has the patient vomited more than once?

·  Is the patient deteriorating?

If the answer to ANY of those questions is YES, please do NOT use this form. These can be signs of a more serious brain injury, so please call 911 or go to an Emergency Room as soon as possible.

If the patient does NOT have any of the four symptoms listed, please click here to proceed to the next screen.

"A physiatrist told me to keep my son home from school for two weeks! The neuro experts at Weill Cornell created a better plan for him, one that let him go to school while also protecting his health."
"I got up and walked out when the doctor at another concussion clinic told me to get used to ‘the new me.’ At Weill Cornell I found brain experts who are helping me get back to the old me – the real me!"
"I couldn't figure out why I was still feeling so ‘fuzzy’ at work, months after my accident. The neuropsychologist at Weill Cornell helped me understand what was going on, and how to get my cognitive skills back."
"Dr. Perrine provided me with individualized care catered to the specifics of my concussion history. Unlike other doctors I had seen, Dr. Perrine understood the type of lifestyle I wanted to lead and worked with me to return my life to as normal as possible, instead of forcing me to dramatically change the way I had been approaching life, which had caused me a lot of unnecessary additional stress."