Skip to the beginning of the images gallery

MRI Prepayment

$0.00

Patient Name

DOB (mm/dd/yyyy)

Order Policy

I certify I have an order for this imaging service. If not, please schedule an appointment with our office

Business Day Delay

If payment made after hours, on the weekend or holiday, your payment may not be posted to your account until the next business day. Please show your emailed receipt at your upcoming appointment.

Refund Policy

I will not be refunded if services are rendered. However, I acknowledge I will be refunded if my provider does not agree with the plan of care and services are not rendered.

Payment Amount

Please Enter the Amount You Are Paying = $1.00

Qty:

Qty

Description

Make payment on your MRI request.

MRI Prepayment

My Account

Support & Information

Secure Shopping

Contact Us

MRI Prepayment

Products from the same brand

My Account

Support & Information

Secure Shopping

Contact Us