HOTLINE: +65 9296 9512

 

MRI EXAMINATION REQUEST FORM (For doctors use only)

Name:*
NRIC/PP:*
Birth Date:
Gender: Male Female
Tel:*
Address:
Test Required*:
  No Contrast With Contrast
Clinical Findings:
Patient's Next Appointment With Doctor:
Date:
Time:
Clinic Stamp:
Date
Female Patients: Pregnant Yes No
Patient's Signature:
Date
Appointment Date:
Appointment Time:
 
 
Urgent appointment please call
Florence +65 9296 9512
 
 
Films/Report
Patient to Collect
Dispatch
Fax Report
 
Payment Mode
Pay at OHM
Bill Clinic
Bill Insurance
 
Doctor's Name & MCR No.:
Please submit the form online and also print a copy for patient to bring along to the clinic.
* Fields are compulsory to fill for submitting online, other fields can fill in after print out.
     

CONTACT US

ORTHOPAEDIC AND HAND MRI (OHM) ORCHARD PTE LTD

1 Orchard Boulevard #05-03
Camden Medical Centre
Singapore 248649

Tel: (65) 6732 1181
Fax: (65) 6732 9971
Email: info@mri.com.sg

Opening Hours:
Monday - Friday: 9am to 6pm
Saterday: 9am to 1pm
Closed on Sunday & Public Holiday

Click here for direction
 

ORTHOPAEDIC AND HAND MRI (OHM) ORCHARD PTE LTD

8 Sinaran Drive #05-18
Novena Specialist Centre
Singapore 307470

Tel: (65) 6339 3512
Fax: (65) 6339 3912
Email: info@mri.com.sg

Opening Hours:
Monday - Friday: 9am to 6pm
Saterday: 9am to 1pm
Closed on Sunday & Public Holiday

Click here for direction
 

ORTHOPAEDIC & MRI (OHM)
NOVENA PTE LTD

Coming soon...
 
Please be punctual and arrive 15 mins before your schedule appointment.