📋 Intake for Topanga Medical — powered by Rempli

📦 Naples Neuro Care New Patient Packet

1
Your Neurosurgery Appointment
2
3

Legal Document

Your Neurosurgery Appointment

Your Neurosurgery Appointment

Welcome to Naples Neuro Care. Your provider has requested a neurosurgery consultation regarding your condition. If you need to cancel or reschedule, we kindly ask that you call us 24 hours in advance. Our contact number is 239-944-5054.

At your first appointment, you will meet our Neurosurgeon or one of our Physician Assistants. Physician Assistants (PA) are healthcare professionals certified by the National Commission on Certification of Physician Assistants who practice medicine under the supervision of a Physician. PA's conduct physical exams, obtain medical history, diagnose, and treat illnesses, order and interpret tests, counsel on preventive healthcare, assist in surgeries, and prescribe medications.

Please gather any recent imaging studies that you have had of your brain or spine, such as X-Rays, CT scans, or an MRI. We will want to see the actual images on CD, not just the written reports. Please ensure these studies are less than 6 months old.

Enclosed is your appointment details and your new patient packet. Please complete all the forms and bring them with you to your appointment. We will try to see you as promptly as possible. Occasionally our providers must leave clinic for emergencies or urgent situations in the hospital and in that case your clinic visit may be delayed. We will make every effort to be thorough and get you in and on your way as soon as possible.

We look forward to meeting you. Welcome to Naples Neuro Care.

Edison Valle, MD, FAANS

Patient Signature Required

Sign here

Draw your signature above using your mouse or finger.

September 12, 2026

Please enter your name and sign above to continue.