For Referring Doctors
Quantitative same-session autonomic protocol with one-week turnaround. Detailed reporting suitable for diagnostic workup, treatment planning, and medicolegal contexts.
When to Refer
Eight indication clusters where autonomic function testing adds the most diagnostic value.
Suspected POTS
Symptomatic orthostatic intolerance with tachycardia on standing — especially in younger patients with disproportionate symptoms or where POTS overlaps with hEDS / MCAS / ME/CFS.
Orthostatic hypotension
Sustained orthostatic blood-pressure fall, with or without a negative cardiology workup. The active stand protocol differentiates orthostatic hypotension and autonomic-failure patterns.
Suspected small fibre neuropathy
Burning feet, distal pain, autonomic features. SudoScan plus the autonomic protocol detects autonomic-fibre involvement and helps build the case for skin biopsy.
Diabetic / chemotherapy autonomic neuropathy
Quantification of cardiovascular and sudomotor involvement — useful for baseline characterisation and tracking progression.
Post-viral / long-COVID dysautonomia
Where symptoms suggest POTS-like physiology or orthostatic intolerance following viral illness. Distinguishes autonomic causes from deconditioning.
Synucleinopathy & atypical Parkinsonism
Demonstrating widespread autonomic failure supports MSA over Parkinson's disease, especially in early or atypical presentations.
Suspected autoimmune autonomic ganglionopathy
Subacute widespread autonomic failure. Characterising the pattern supports the case for ganglionic AChR antibody testing and immune therapy.
Pre-treatment baseline
Patients about to start treatments that may have autonomic effects, or where baseline characterisation is requested for medicolegal documentation.
Not sure if a patient fits? A brief phone discussion before the referral is welcome — call the rooms on 02 9388 0615. The phone is staffed during business hours and your call will be triaged appropriately.
How to Refer
A standard specialist referral by any of the routes below. We confirm receipt and contact the patient directly to arrange an appointment.
Email or fax
Send a standard specialist referral to Dr Ron Granot (Neurology) or Dr Jason Kaplan (Cardiology) at Autonomics Australia / East Neurology. Contact details on the right.
E-referral
Standard GP-software e-referral works — addressed to either specialist by name. We accept HealthLink and other common networks.
What to include
Brief clinical summary, presenting symptoms, key prior investigations (especially cardiology workup), current medications, and the specific clinical question being asked. This helps us triage and tailor the protocol where needed.
Please flag at referral
Implanted electronic devices (pacemakers, ICDs, neurostimulators), pregnancy, or unstable cardiovascular status — so we can plan the protocol appropriately.
Send a referral to
Dr Ron Granot (Neurology) · Dr Jason Kaplan (Cardiology) · Autonomics Australia / East Neurology
What Your Report Will Contain
A single integrated document, issued to you within one week of the testing session.
Quantitative results
For each of the five tests — active stand with recovery blood pressure, paced-breathing HRV, Valsalva, isometric handgrip, SudoScan — measured values are reported alongside age-matched normative ranges.
Pattern interpretation
The autonomic pattern is characterised across the three domains:
- Cardiovagal (parasympathetic) — E:I ratio, Valsalva ratio
- Adrenergic (sympathetic) — Valsalva BP recovery, active stand blood-pressure response, isometric handgrip response
- Sudomotor (small fibre) — SudoScan electrochemical skin conductance
Integrated clinical interpretation
The findings are framed against the clinical history you provide. The report identifies whether the pattern fits POTS, orthostatic hypotension, length-dependent autonomic neuropathy, generalised autonomic failure, or another recognisable pattern.
Suitable for use in
- Diagnostic workup — supporting documentation for the autonomic component of a diagnosis
- Treatment planning — for medication selection and titration
- Medicolegal contexts — quantitative documentation of autonomic involvement
- Insurance and disability assessments
Turnaround & Logistics
Time to appointment
Most patients are accommodated within 1–2 weeks. Urgent cases — particularly suspected autoimmune autonomic ganglionopathy or rapidly evolving autonomic failure — are prioritised.
Time to report
Detailed report issued within one week of the testing session. Substantially faster than the 6–12 month report turnaround at public autonomic units.
Report delivery
Report sent directly to your nominated email or fax. Copy retained in the patient record. Patient can request a copy on follow-up.
Billing
This is a private specialist practice. Autonomic function testing does not attract a Medicare rebate — none is available for this testing. A fee estimate is provided on booking.
Clinical FAQ
Which patients benefit most from autonomic function testing?
Patients with suspected POTS, orthostatic hypotension after a negative cardiology workup, suspected small fibre neuropathy (with or without autonomic features), diabetic or chemotherapy-related autonomic neuropathy, post-viral or long-COVID dysautonomia, suspected autoimmune autonomic ganglionopathy, and patients with atypical or early synucleinopathy where demonstrating autonomic involvement supports the diagnosis.
What does the report contain?
A detailed quantitative report covering each of the five tests with measured values against normative ranges, integrated clinical interpretation, summary of autonomic domains affected (cardiovagal / adrenergic / sudomotor), pattern recognition (e.g. autonomic failure, length-dependent autonomic neuropathy, POTS pattern). Suitable for subspecialty workup, medicolegal documentation, and treatment planning.
How quickly can a patient be seen and reported?
Urgent patients are typically accommodated within 1–2 weeks. Reports are issued within one week of the testing session. Substantially faster than the 6–12 month waitlists common at public autonomic units.
What information should accompany the referral?
A brief clinical summary including the relevant history, presenting symptoms, key investigation results (especially any cardiology workup, blood tests, prior nerve studies), current medications, and the specific clinical question being asked. This helps us triage appropriately and tailor the protocol where needed.
Are there contraindications or modifications I should mention at referral?
Yes — please flag implanted electronic devices (pacemakers, ICDs, neurostimulators), pregnancy, or unstable cardiovascular status. SudoScan is omitted with implanted devices or in pregnancy; the active stand and handgrip portions may be modified depending on the cardiovascular picture. Knowing in advance lets us plan the protocol appropriately.
Send a Referral
Quantitative same-session protocol. Detailed reporting in one week. Bondi Junction.
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