Information for referring physicians

At the present time, patients may be referred for evaluation of:
  1. Glut-1 DS (glucose transporter type-1 deficiency syndrome)
  2. MELAS (mitochondrial encephalopathy, lactic acidosis and stroke-like episodes)
  3. MERRF (mitochondrial encephalomyopahy with ragged-red fibers)
  4. Pyruvate dehydrogenase deficiency
  5. Pyruvate carboxylase deficiency
  6. Ion channel disorders
  7. Genetic and metabolic encephalopathies of unknown origin
  8. Genetic and metabolic myopathies of unknown origin

There may be fees associated with the evaluation.

Upon review of this information, if warranted, further documentation and blood samples of the patient and immediate relatives may be requested. None of the items received will be returned. Therefore, only copies should be provided.

A. GENERAL REFERRALS (EXCLUDING Glut-1 DS)

All referrals must be made using the following forms and signed by patients and/or parents and the referring physician. They should be sent via regular mail to the address listed below. Please read the form instructions and conditions carefully.

Download Physician Referral form (do not use for Glut-1 DS)
MS Word File | PDF File



B. Glut-1 DS REFERRALS

Prior contact with us is required. No documents or samples will be accepted without our prior approval. Please call either the lab or one of the coordinators listed below before sending any information. After contact has been made and approval acquired, referrals may be sent via regular mail or electronically to the address listed below. Please read the forms instructions and conditions carefully.

Download Physician Referral form (Glut-1 DS only)
MS Word File | PDF File

Contact Information:

Colleen Giblin Laboratories, Box 81
Columbia University Medical Center
Neurological Institute of New York
710 West 168 th Street
New York, NY 10032

Laboratory phone: 212-305-8245
Laboratory fax: 212-305-0431

Clinical Coordinators:
Kristin Engelstad Phone: 212-305-6834 || Fax: 212-305-0431 E-mail: ke4@columbia.edu
Vanessa Battista Phone: 212-342-2920 || Fax: 212-305-0431 E-mail: vb2109@columbia.edu
Disclaimer:

• The results of any evaluation or assessment may not be considered for clinical use and will be provided only on a research basis, unless specifically documented in writing by us. They are not intended to supersede or modify the clinical judgment of the referring or treating physicians. The staff of the Laboratories will not become treating or consulting physicians in any case, unless specifically documented in writing by us.

The Colleen Giblin Laboratories, staff, its funding and supporting institutions will not be liable for any consequences derived from the knowledge or use of any information provided to the involved health professionals or to the individuals studied.





©2007 The Colleen Giblin Research Laboratories for Pediatric Neurology • 710 W 168th St, New York, NY 10032 • Updated September 9, 2008 • Comments