If you are a new patient at Cognitive Assessment Group in NYC and Chicago, you will need to fill out some new patient information. With your new patient information, we can quickly and effectively provide quality evaluation and care for your neuropsychological disorders.
We will review these forms at your first appointment. If you have any questions regarding our new patient information forms and questionnaires, please ask us during your first appointment, and we will be happy to help you.
Please fill out the online form or print out and complete these materials and bring them with you on the day of your appointment
Adult History Questionnaire
Fill out the online form or download the PDF and fill out the form
Child Intake Form
Fill out the online form or download the PDF and fill out the form
Insurance
Neuropsychological assessment (or psychoeducational testing) is covered by many insurance plans that provide out of network benefits. We will assist you in determining your coverage for the testing.
The health insurance environment can be daunting and overwhelming. Let us deal with them so you don’t have to. This includes determining your benefits, negotiating fees with your carrier if there is no in-network specialist available, obtaining pre-approvals, and using our electronic billing for our services. Our billing manager can do the investigating for you so that you know your benefits and can make the choice most appropriate for your situation. Call us today to start this process.
- United Healthcare
- Aetna
- Empire Blue Cross/Blue Shield PPO (New York only)
- Federal Blue Cross
- The Empire Plan
- No Fault
- UMR
- CoreSource
- Oxford Freedom Plan
- Value Options/Beacon Health
- United Student Resources
- Wellfleet
This is not an exhaustive list. Please contact us if you have out-of-network benefits with your insurance plan but do not see your provider on this list.
Credit Cards
We accept, Visa, Mastercard, American Express and Discover

Office Locations
Manhattan
240 Central Park South
Suite 2B
New York, NY 10019
212.784.6105
Chicago
333 N. Michigan Avenue
Suite 1801
Chicago, IL 60601
312.620.0814
Testimonial
Dear Dr van Gorp,
I am very grateful of the efforts you and your assistant have put, and the professionalism and accuracy you guys have demonstrated during this series of testing, especially on the part of testing in Chinese you two have provided.
I am glad that I could truly find out exactly who I am and what I should really improve in my weakness and fully make use of my talents in my education and future career.
I am looking forward to receiving the final report by mail.