MyLVHN -

If you or a loved one suffered a concussion you may feel anxious and overwhelmed. Meeting with our highly specialized concussion treatment team with the Lehigh Valley Institute for Surgical Excellence will give you peace of mind in understanding your your diagnosis and treatment options, including vision therapy.

We'll meet with you to:

Confirm a diagnosis
Explore all treatment options, including treatments or procedures that may not be widely available
Discuss what treatment or care plan is the best fit for you
Ensure you're confident in the approach and expertise of your care team

After completing the form below, a team member will call you to setup an appointment with one of our specialists.

Your Contact Information

First Name:

Last Name:

Date of Birth:

Phone:

Address:

City:

State:

Zip Code:

Email Address:

Second Opinion Questionnaire

As a reminder, second opinion appointments are only for those who are not current patients of these practices. If you are a current patient and you have any questions about your care, including your diagnosis or treatment option, your care team will be happy to discuss them with you.

Which healthcare organization did you receive your diagnosis from?

If other, please specify:

Are you already a patient of LVPG Concussion and Head Trauma Program?

Yes

What is your diagnosis or concern?

Is there a specific question you have about your diagnosis?

Request a Second Opinion Appointment for Concussion Treatment