Patient Forms and Documents


We approve most MRI treatments with NO upfront cost and NO OUT OF POCKET FEES ARE EVER BILLED TO OUR PATIENTS. 


MRI Healthgroup is not an insurance company and we do not have predetermined rates for medical services. We pay Medical Providers on behalf of patients without health insurance coverage and rely on reimbursement from their pending Personal Injury or Workers Compensation claim(s).

We pay MRI Imaging providers in advance for most diagnostic MRI services. MRI providers in our network know exactly how much they will be reimbursed for their services and they receive payment in advance of services being rendered.  There are no lengthy forms to complete. 


Patients receive MRI on a Lien or letter of protection basis (signed by their attorney) with no out of pocket cost of obtaining a MRI.   


If you are a patient represented by an attorney or workers compensation adjuster who was injured as a result of an auto accident, at work or another party's negligence,  MRI Healthgroup will help you find a quality MRI Imaging center with no out of pocket cost, fees or interest.


Our experienced beauty and wellness professionals are constantly up to date with the latest trends and best practices. We are passionate in bringing you fresh looks and styles.



Download Patient Forms Below


MRI Healthgroup MRI Imaging Order Form
MRI Healthgroup MRI Imaging Order-Referral Form
Adobe Acrobat document [91.1 KB]
MRIhealthgroup Patient Medical Lien Letter of Protection Form
MRIhealthgroup Patient Medical Lien Letter of Protection Form - patient financing for personal injury, workers comp, and auto accident cases
Adobe Acrobat document [31.5 KB]

Contact Us Today!

MRI Healthgroup
2727 West Paces Ferry Rd Bldge One

Suite 750

Atlanta, GA 30339

Phone: (770) 702-0909
Fax: (800)467-1066

Our business hours

Monday - Friday09:30 AM - 04:30 PM

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