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Get Mri Referral Form
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How to fill out the MRI Referral Form online
Filling out the MRI Referral Form accurately is essential for ensuring that the referral process runs smoothly. This guide will walk you through each section of the form, providing clear instructions to help you complete it online with confidence.
Follow the steps to complete the MRI Referral Form
- Press the ‘Get Form’ button to access the MRI Referral Form and open it in your preferred editor.
- Input the patient's details in the 'PATIENT' section. Include the NHS number, forename, surname, and address. Remember, referrals cannot be accepted for patients under 16 years of age or for breast MRI.
- Fill out the 'REFERRER' section with your personal information, including your name, GMC/HPC/NMC number, address, date of birth, and telephone numbers (home, work, and mobile). Also, provide your email address and indicate the gender of the patient.
- Answer any relevant questions regarding physical or communication difficulties, NHS funded transport eligibility, and the need for an interpreter, specifying the language if required. Ensure to note if the patient is a wheelchair user.
- In the 'PRESENTING COMPLAINT & PROVISIONAL DIAGNOSIS' section, provide detailed clinical information to assist with the interpretation of the referral and images. Tick the box if the scan is related to recent spinal or neurosurgery, and indicate the necessary investigations along with the relevant side of the body and body part.
- Complete the MRI safety questions by indicating whether the patient has any implanted metallic devices or known metallic fragments in their eyes.
- Finally, enter the date of referral. Once all sections are completed, save changes, download, print, or share the form as needed.
Complete your MRI Referral Form online today to ensure timely processing of your request.
The average MRI Cost in Australia is $375 out of pocket, and no rebate from Medicare if the referral is written by a health professional other than a Surgeon or Specialist.
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