Referral Sheet If you do not have a requisition already, your Doctor prefers using our requisition form or you are using a Chiropractor as the referring Doctor, use this form Referral Sheet.pdf Adobe Acrobat document [40.5 KB]
Patient Intake Form This is a general patient information form we need filled out before you can have your scan. We greatly appreciate if you could fill it out before your appointment and email it back to your customer service representative. If you have any questions please contact us. pembina-mri-patient-intake-form.pdf Adobe Acrobat document [80.3 KB]
These forms give our doctors backround information so they can better diangose your injury or condition. Please chose the form that is appropriate for the scan you are having.