Change of Address or Psychiatrist Form

If you do not live in the United States, please go to our International website for more information.

Please provide the following information:

Patient Information

First Name:
Last Name:
E-mail Address:

Previous Address

Address 1:
Address 2:
City:
State:
Zip Code:
Telephone Number:

New Address

Address 1:
Address 2:
City:
State:
Zip Code:
Telephone Number:
Date of Move:

New Psychiatrist

Psychiatrist First Name:
Psychiatrist Last Name:
Telephone Number:

Mailing Address

Cyberonics, Inc.
Attn: Device Tracking
100 Cyberonics Boulevard
Houston, Texas 77058

 

    
 
   
© Cyberonics, Inc. 2007  
       
  UNITED STATES INDICATION FOR USE:
The VNS Therapy System is indicated for use as an adjunctive therapy in reducing the frequency of seizures in adults and adolescents over 12 years of age with partial onset seizures, which are refractory to antiepileptic medications.

VNS Therapy (or the VNS Therapy System) is indicated for the adjunctive long-term treatment of chronic or recurrent depression for patients over the age of 18 who are experiencing a major depressive episode and have not had an adequate response to four or more adequate antidepressant treatments.