top of page

                                         Getting Started 

  1. Call the office and make an initial appointment. For PANDAS/PANS, all initial appointments are either on the phone or in-person WITHOUT the child present. There are several reasons for this, the main one being that this appointment is dedicated to the review of your child’s medical and developmental history, and prior records. We have discovered through many appointments with many PANDAS children that sitting in these appointments are very stressful and even scares them. Many of them have been to multiple providers and have heard this story of their serious medical issues repeated over and over. We prefer to protect your child from this and have an appointment where we can talk frankly as adults. I suggest that in general, consider talking less about your child's medical issues in front of your child.

  2. Fill out all the paperwork and send it back before the appointment. (Documents attached below.)

  3. Write up a simple TIMELINE of your child’s medical history, and send it. It will be helpful. If you don't, just think about it and consider jotting down a few notes before we talk, of your child's early medical history and development.

  4. Send as many labs as you can that your child has had since they began being worked up for PANDAS/PANS symptoms. If this has gone on for several years, try to send all the labs you have anyway. We really like looking for clues in old labs.

  5. Please send at least one photo of your child, a good closeup. Also appreciated is a general picture of them and if they have a rash you want to talk about, please send a photo of the rash.

  6. Once we have an initial conversation about your child, you will need to bring them into the office for an exam if you would like us to treat and prescribe medication. If you are looking for a second opinion or, if you are working with another primary provider and you would like us to act as consult or guide, you would not necessarily have to bring your child into the office. However, it’s always helpful to see and examine any child when we are working with their health. Also, please check in with your provider FIRST to be certain they are really open to working with a PANDAS/PANS specialist. If they are, I'm happy to work together with them.

  7. Please see the Office Policies page, thank you.

Documents to Complete Ahead of Time



Please complete these documents and return them to the office with your

child's medical records or lab tests

no later than three days before the appointment.

Fax: 1 650 241 1129  or  email 


Amy Joy Fishman Smith

Nurse Practitioner

bottom of page