(512) 459-4315 admin@mri-tx.com


Forms and directions for visits.


Please complete the appropriate questionnaire(s) in advance of your evaluation to enhance the quality of your care and save time during your visit. Forms can be sent by email or by physical mail.

Evaluation Day

Please wear comfortable clothes. If you are coming for a neuropsychological evaluation, you should plan to be in the office for the majority of the day. Please bring with you anything that you might need during the day, including snacks and drinks, medications, corrective lenses, prosthesis, orthotics, etc. There are several places nearby to eat or bring a lunch if you prefer. We will need to know all medications you are currently taking including the name, dosage, and how often you take the medication.

Please call 512-459-4315 with any questions or concerns.


To save you time and enhance the quality of your care, we have provided our patient forms online. Please select the appropriate form, fill it out, and email or mail it to us prior to your appointment and/or telephonic interview.

If you are coming to the office for an examination, or if someone from our team is coming to your home, you will be asked to complete the following forms:

  1. Informed Consent for IME
  2. HIPPA Authorization Form
  3. Medical Photography Consent Form

For our interviews, and for gathering information for our examinations, you will be asked to complete one or more of the following forms:

  1. Child History Form
  2. Adult Questionnaire 
  3. Life Care Plan Survey
  4. Symptom Survey – Family Member

Con la intención de ahorrar tiempos y mejorar las atenciones prestadas, hacemos disponibles en línea nuestras formas para pacientes. Favor de seleccionar la forma adecuada para su caso, imprimirla, llenarla con la información solicitada, y traerla ya completa a su cita.

  1. Cuestionario Infantil
  2. Encuesta para el Plan de Cuidado de Vida
  3. Cuestionario Neuropsicologico para Adultos
  4. HIPAA Autorización Para Divulgar Información Personal del Paciente
  5. Formulario de Consentimiento Para Fotografía Médica
  6. Formulario de Consentimiento Informada


We are located at 301 Denali Pass, which is off of West Parmer Lane between Kenai Drive and Glacier Pass Lane. Our building is on the West side of the road, in Suite 4, between Mid-America Mortgage Inc. and Hall Plastic Surgery & Rejuvenation.

Office Address: 301 Denali Pass, Suite 4 Cedar Park, TX 78613

Phone: 512.459.4315

Fax: 512.459.4318

MediSys Office

<p><strong>Phone: </strong>512.459.4315</p>