The following forms are used by Michigan Resonance Imaging. Some of them must be completed before the scan can take place. If you desire, you can download the forms from this page and fill them out prior to your appointment to speed up the process and reduce your waiting time.
Privacy Policy

This notice describes how medical information about you may be used and disclosed and how you can get access to this information.
Consent Agreement This form must completed prior to recieving your MRI
Health and Safety Policy This notice answers safety related question you may have about getting an MRI.
Breast Screening Form This comprehensive questionnairre gets filled out for a breast screening exam.
General Prescription Form All patients must fill out this form before getting an MRI. Please bring this form with you for your appointment.
Patient Medication Profile This form includes the listing of all medications that you are currently taking on a routine basis.
  To view these documents requires Adobe Acrobat Reader. If not installed on your computer, dowload it for free.
     
 
 
 
 
 
 
Contact us as at 1-800-233-0272