Resources for Physicians and Clinics and Patients

MRIreferralform
Downloadable Referral Form

Patients,  download a referral form and take it to your doctor.  Or, call us, and we’ll arrange the referral directly with your doctor’s office.

 

Our relationships with our referring physicians are one of the things we value most, and we look forward to working with you!

Download Referral Form

NW MRI Referral Form 2-3-16

Request Brochures or Referral Cards

Call us 541 570- 1728 if you would like to order multiple referral forms, patient brochures or referral cards.

 We support a Patients Right to Choose Their Test Facility

Patients have the right to choose their test facility:

ORS 441.098

(4a) If a health practitioner refers a patient to a facility for a diagnostic test or health care treatment or service, the health practitioner or the practitioners designee shall inform the patient, in the form and manner prescribed by the Oregon Health Authority by rule, that:

  • (A) The patient may receive the test, treatment or service at a different facility of the patients choice; and
  • (B) If the patient chooses a different facility, the patient should contact the patients insurer regarding the extent of coverage or the limitations on coverage for the test, treatment or service at the facility chosen by the patient.

(4b)Rules concerning the form and manner for informing a patient as required by this subsection shall:

  • (A) Be designed to ensure that the information is conveyed in a timely and meaningful manner;
  • (B) Be administratively simple; and
  • (C) Accommodate a providers adoption and use of electronic health record systems.

(5) A health practitioner may not deny, limit or withdraw a referral to a facility solely for the reason that the patient chooses to obtain the test, treatment or service from a different facility.

(6) The authority may not impose additional restrictions or limitations on any referral described in this section that are in addition to the requirements specified in subsections (3) and (4) of this section.

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