Clinical Evaluations in our 22q Healthy Minds Clinic
Healthcare professionals from the UC Davis Departments of Pediatrics, Psychiatry and Behavioral Sciences provide services. We collaborate with the MIND Institute research program in chromosome 22q11.2 deletion (VCFS/DiGeorge) syndrome to inform our clinical work. A Developmental Pediatrician, Child Psychiatrist and a Licensed Clinical Psychologist comprise the clinic’s professional staff. Clinical assessments are currently available on the 2nd Wednesday and 4th Monday of the month.
The following services are offered to children ages 14 and younger:
- Developmental or Neuropsychological Examinations (ages 14 and younger)
- Medical Consultation
- Consultation/Management of Medications
Families who would like their children seen in our clinic should:
- Directly contact their insurance company and establish that medical and behavioral health benefits are available and authorized.
- Make an appointment with their child’s primary care physician to discuss their concerns and reasons why they want their child examined at our clinic.
The primary care physician (PCP) MUST:
- Provide a written report of the child’s medical history, physical examination, and reason for referral.
- Request authorization from the patient’s insurance company for the following CPT codes required for consult/evaluation: 96111, 96116, 96118, 99205, 99354, 99366, 99367, 90885. PCPs may want to review our sample medical justification letter (PDF) »
- Complete the MIND Institute Clinic Referral (PDF) » sheet (fax to 916-703-0350), and
- Call the UC Davis Physician Referral Center at 800-482-3284.
Parents may then contact June LaMarr, New Patient Referral Coordinator, at 916-703-0440 to initiate the referral process.
Once the referral has been received, Dr. Romina Stanislavsky will review the referral and contact the family to assign the proper providers.
Referrals are tracked through a 5-step process:
- Receives referral with PCP’s History and Physical Examination report.
- Gathers supporting records.
- Triages to appropriate specialty services.
- Obtains insurer’s authorization for specialty services.
- Appointment scheduled.
What information should be provided with the referral?
- Patient's current and past medical and developmental history, along with the last PCP appointment documenting a physical examination.
- School/Agency records if applicable, including current 504 plan, Individual Education Plan (IEP), most recent psychoeducational or eligibility evaluation reports, Individual Family Service Plan (IFSP) or Individual Program Plan (IPP).
- Copies of previous diagnostic or psychiatric evaluation reports, including Mental/Behavioral Health, Speech/Language, Occupational Therapy, etc.
- Completion of a patient intake questionnaire and other behavioral questionnaires prior to the appointment.
What are the payment options?
Insurance and self-pay options are available.
Current professionals in the clinic include:
To help us expand these critical services to those without adequate health insurance and join with many previous generous private donors to support the clinic, please visit the on-line donation form ». In the box marked special instructions for this gift please write, 'For 22q11.2DS activities/Dr. Tony Simon'. You can also send a check to the MIND Institute directly and mark it 'In support of 22q11.2DS clinic/Dr. Tony Simon'.