Partner Physicians’ Information Form

Join our Partner Physicians’ Network (to be filled out by physicians only)

The clinical subspecialty of neuroimmunology has grown remarkably over the past decade, with causes and contributors to autoimmune encephalitis and associated diseases continuing to expand. The Anti-NMDA Receptor Foundation remains committed to improving recognition of patients with autoimmune encephalitis, and to improve patient and physician access to educational and clinical resources that will contribute to better care and outcomes. We need your help to make this happen. If you are a clinician with expertise in the assessment and management of patients with anti-NMDA receptor encephalitis and other forms of autoimmune encephalitis, we are pleased to extend an invitation to join The Anti-NMDA Receptor Encephalitis Foundation’s Partner Physicians Network.

The Partner Physicians Network is intended to establish points of contact between partnered physicians and the Foundation, facilitating patient referrals, and establishing a mechanism for bilateral dissemination of information pertinent to the diagnosis and care of patients with autoimmune encephalitis. Responsibilities of Partner Physicians would be limited to responding to the occasional communication from the Foundation that may pertain to specific needs of patients in or near your practice location. Additionally, your name and practice location would be listed via our website, identifying you as a Partner Physician.

We also encourage you to consider joining the Autoimmune Encephalitis Alliance’s Clinicians’ Directory. The Autoimmune Encephalitis Alliance is headquartered in Durham, North Carolina and is working in partnership with the Foundation to grow their own North America-wide “Clinicians Network”. Information on how to join can be found via the following link:

Thank you for your continued commitment to improving the care of patients with autoimmune encephalitis. We look forward to adding your name to our Partner Physicians’Network, and to supporting your clinical and research efforts. Please fill out the form below and submit. Alternately, you may download the following pdf form, save it and send as an attachment to

Please feel free to contact our Foundation ( with any questions that you may have concerning this invitation, or any other queries pertaining to autoimmune encephalitis.

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    eg MD, PhD

    This will never be shared without your consent and is solely for the use of communication between the Foundation and you.

    (for Ontario Clinicians Only)