Referral Form

If you are a physician’s office and would like to refer a patient to Greater Flint MRI, please print this file below.  Complete the form on Page 1 and fax to 810-230-2515.  Please give Page 2 to your patient as it contains valuable information regarding MRI procedures, safety precautions, and directions. 

Thank you for your referral.  We will take excellent care of your patient.  Furthermore, we provide you will the detailed images and reporting that will assist you in the diagnosis and treatment of your valued patient.