Schedule a New Case

Schedule a New Case
Call 800-638-7564 to schedule a case. All same day and next day cases should be scheduled by phone.

Email: NCSScheduling@globusmedical.com

All Cases will be scheduled within 24-48 hours and you will receive a confirmation number.

Need to Change an Existing Case or Cancel An Existing Case?

Click Here to Change or Cancel an Existing Case
Case Details
Date of Surgery*

MonthDayYear
For Same Day or Next Day Cases Please Call 800-638-7564
Surgery Start Time/End Time*

Estimated Start Time

Until
until
Estimated End Time
Total 0.0
Hospital*
Surgeon*
Procedure Type*
Please Select a Procedure Type
Diagnosis Code
ICD-10 Code
IONM Services Requested (Select Multiple If Applicable)

SSEPEMGTCMEPPDS(Pedicle Screw Stimulation)EEGBAER (Brainstem Auditory Evoked Potentials)NAP (Nerve Action Potential)MCM (Motor Cortical Mapping)SCM (Sensory Cortical Mapping- Phase Reversal)CN (Cranial Nerves)DBS (Deep Brain Stimulation)Direct Nerve StimD-Waves (Direct Spinal Cord Monitoring)ECoG (Electrocorticography)TMAP (Transabdominal Motor Action Potential)LCM (Language Cortical Mapping)TCD (Transcranial Doppler)VEP (Visual Evoked Potentials)Other
Procedure Notes/Description*
Procedural details, e.g., ACDF C5-7 or left suboccipital craniotomy for tumor. Details help our team best prepare for the case.
Supporting Documents Upload

Upload Relevant Documents Such As Facesheet's or H&P's Here
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Patient Details
Patient Full Name*

Patient First NamePatient Last Name
Patient Date of Birth*

MonthDayYear
Patient Phone Number
Please enter a valid phone number.
Patient Gender
Patient Primary Insurance Carrier*
Patient Primary Insurance Policy Number*
Patient Secondary Insurance Carrier
Patient Secondary Insurance Policy Number
Patient Address

Patient Street Address

Street Address Line 2

Patient CityPatient State / Province

Patient Postal / Zip Code
Additional Patient Notes
Requestor Information
Requestor Full Name*

Requestor First NameRequester Last Name
Requestor Email Address*
example@example.com
Requestor Phone Number*
Please enter a valid phone number.
Should be Empty:

Schedule a New Case

Case Details

Patient Details

Requestor Information