Full Body MRI Scan

Self Referral Form

 

All information is treated in strict confidentiality and will only be shared with third parties who are involved in your care.

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Any specific requirements, please highlight:

NHS GP

It is a requirement that we communicate results to your NHS GP in order that they can make recommendations about your future care. By signing below, you acknowledge and accept that:

  • A copy of your report will be sent to your GP
  • Neither the radiographer who has conducted the scan/form or the radiologist reporting it can discuss the findings of the scan with you; and
  • You have read and understood the Patient Information below.
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Patient Information


Increasingly patients wish to take greater control of their own health and are becoming more aware of the opportunities to self-investigate their health issues, or simply reassure themselves that they are well.

To this end, Vista Health welcomes patients (“you”) who wish to refer themselves for MRI scans. You need to be aware of and agree to the following important information prior to proceeding with a self-referral booking:

  • Scans will only be offered to all those aged 18 and above.
  • MRI is extremely safe and does not involve any radiation exposure.
  • You will need to complete a self-referral form, detailing the reasons why you wish to have a scan. If it is for a medical complaint, this should be self-documented. If it is for reassurance, that too should be stated.
  • We will not accept self-referrals from you if you are engaged in professional sports or for anything connected with a professional sports club of which you are a member.
  • Scans will only be performed on the body areas related to the package chose.
  • Self-referrals will not be accepted if you have cancer or a long-term medical condition related to the area of concern.
  • You accept you are solely responsible for selecting the area you want to be scanned and that you are not relying on any input in this regard, whether clinical or otherwise, from Vista Health.
  • You must be registered with an NHS GP, to whom a copy of the report will be sent and with whom all discussions about your future care must take place. We cannot enter into any such discussions with you.
  • We cannot perform scans if you cannot, or do not wish to provide the name of your GP.
  • You will be required to complete a safety questionnaire at the time of booking which may exclude you from proceeding with the scan or delay it, depending on the information you provide. It is very important that you tell us about anything which could affect our ability to scan you safely.
  • If you require further information or would like to query the content of the report, the request must be raised by a GP or medical professional.
  • You must understand that MRI scans may on occasion identify unexpected abnormalities which may or may not require further investigation. If so, these findings will be identified on the report and any recommendations arising will be followed up by your GP.
  • You may bring a friend or relative with you, who may, if required, stay with you for the scan itself, subject to safety checks. Unfortunately, you may not bring children under the age of 16 to accompany you.
  • If you cancel your appointment with less than 48 hours’ notice charges will occur that you will have to pay. This will be subject to discretion for unavoidable absence due to illness, travel disruption etc.
  • You will normally receive a CD containing your images following the appointment and the radiology report will be sent to your nominated GP within 3 working days of the investigation.
  • The NHS and private medical insurance companies will not fund or cover self-referrals. All self-referrals are undertaken on a self-pay basis only.
  • You accept that the General Patient Terms and Conditions (as provided to you in your appointment pack) apply to the services provided to you by Vista Health.