My First Visit

Below are some important documents to help our team move you through the initial assessment process. In order to provide you with the best treatment possible, it is important for us to gather all the information we can about what it means to be you!

Before your first visit, please download and complete the documents below. If you do not have access to a printer, reading the documents over prior to your appointments is also helpful.

Intake Form

Your first visit will start with a private consultation with Mark Llewellyn Smith LCSW, BCN, QEEGD. The intake process is a basic but thorough consultation analysis in order to assess your initial concerns, medical history and appropriate treatment protocols. Filling the Intake Form out prior to your first appointment can drastically speed up the intake process.

The form includes questions regarding patient demographic information, occupation/education, family demographics and family history, sports and hobbies, personal medical history, recent symptoms history (past 12 months), illnesses, accidents and significant stresses, and reasons for coming into the office. Answering these questions as accurately and thoroughly as possible will ensure that the neurofeedback intervention chosen by the clinician is best suited for your needs.

Instruction Form

Following the initial assessment, you will be scheduled for a comprehensive QEEG brain map.

The QEEG, or quantitative electroencepaholgram, is a revolutionary tool in brain-based therapy that allows us to visualize and “map” the baseline activity of your brain. This appointment sets the tone for your treatment strategy, as the clinician uses the results form your Q to design specific treatment protocols fitted to your needs.

Many variables can affect the quality of the QEEG assessment including the integrity of the electrode adhesion (clean scalp, no hair products), as well as chemical alterations within the brain such as consuming alcohol or coffee, keeping track of medications, and getting a quality night of sleep prior to your appointment.

In order to capture the quantitative assessment of your baseline state and level of functioning, it is integral that you carefully follow the preparations as instructed. The QEEG report takes anywhere from 7 to 14 days to process. You may choose to begin neurofeedback training before the report is complete.

Instruction Form →

Informed Consent Form

Prior to embarking on your neurotherapy journey, it is important that you understand and consent to how a session is conducted. This form must be brought in during your QEEG session. 

Following the results of the QEEG, you will be scheduled for your first neurofeedback training session. This includes electrode placement and adhesion, chosen treatment protocols, as well as session duration, instruction and frequency. Learn more about the training here. Last but not least, it is extremely important that all clients keep open communication with the clinician throughout their training regarding in-session state changes as they occur. This allows the clinician to mold the protocol to fit your needs as precisely as possible, adjusting the parameters as you work together.

Informed Consent Form →

Schedule Your Initial Consultation

Thank you for choosing Neurofeedback Services of New York! Now that you know how it works, you may request an initial consultation appointment online or by calling our office at 212-877-7929.

We look forward to helping you become the person you were meant to be with Neurofeedback.

Schedule online →

Try Neurofeedback Therapy and improve your mental health today!