Provider List Suggestions

Do you have a provider that is part of your PANS PANDAS team that you suggest for ASPIRE’s provider list? If so, please double-check that they are not already on our list. Simply visit ASPIRE Provider List and enter in the city and state to search. If they are not on the list, please fill out the form below.

Please fill out the brief form below.

If you have any questions, email Gabriella. Please sign up for the ASPIRE newsletter.

Provider's First Name(Required)

Provider's Last Name(Required)

MD, PhD, LCSW, DO, etc(Required)

Area of Specialty - can list more than one if appropriate(Pediatrician, Integrative, Therapy, Infectious Disease, Psychiatry, LLMD, etc)(Required)

Do they see Adult PANS PANDAS Patients?

Yes

Unsure

Name of Practice(Required)

Practice Address(Required)

Practice Website

Number

Practice Phone

Practice Email

Feedback – Why do you think they should be added to your list? Do they see many patients, what have they done effectively? Any negative experiences? etc(Required)

Your Name(Required)

Your Email(Required)

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Provider List Suggestions

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