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Neurology Center of Fairfax

703-876-0800
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    Neurology Center of Fairfax is implementing Patient Connect by Luma as a way for you to complete your forms online before coming to the office.
    You will receive a text from (703) 574-0867 with your appointment confirmation, reminders, and forms link.
    Please call our office with any questions.

Requesting Forms or Letters

Instructions:

To request disability forms to be filled out by your provider, please complete the two forms below. Fill out the forms in their entirety and click submit at the end.

  • Disability form instructions (PDF)
  • Disability Form
  • Disability Form (PDF option)
  • FMLA Form
  • FMLA Form (PDF option)
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To open and view the PDF forms above, download the free Acrobat Reader.


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Locations

Fairfax Office
3020 Hamaker Ct, Suite 400
Fairfax, VA 22031

703-876-0800 | Fax: 703-876-0866
Reston Office
1830 Town Center Drive, Suite 305
Reston, VA 20190

703-876-0800 | Fax: 703-876-0866
Sleep Diagnostic and Treatment Center
3020 Hamaker Ct, Suite 400
Fairfax, VA 22031

703-876-2850 | Fax: 571-308-1158
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