Our imaging centers are modern, state-of-the-art imaging facilities conveniently located in the Southeast, designed to make diagnostic testing a much more pleasant and relaxing experience. We are committed to making your appointment experience very pleasant. Our patients can tell that we are there for them, from the reception area through the technologists and radiologist. Our hospital-quality imaging facilities are designed to make your experience as pleasant and relaxing as possible. We hope that you will choose us for your diagnostic imaging needs.
following when you come for your visit:
Driver’s License/Photo ID
Completed Forms (See Patient Forms Below)
Physician’s Order (If not already faxed to us by your physician)
List of Medications
Any Special Instructions
Southern Radiology Specialists now offers Health Screening for many common, life threatening medical conditions. Some may not be covered by your insurance company. However, these procedures are becoming recognized by the American College of Radiology and United States Department of Health as important in the detection and prevention of disease.
Patient registration forms are available below for your convenience. You may complete the forms prior to your appointment to help speed up the registration process. There are 3 options:
1. Complete the fillable PDFs, save the forms to your computer, then email them to us at email@example.com
2. Print the forms, complete them, and bring them with you to your appointment
3. Print the forms, complete them, and mail them to our office (if there is enough time to do so). Our mailing address is Open MRI of Jackson, 120 Stone Creek Blvd., Suite 900, Flowood, MS 39232
MRI Procedure Screening Form, No Contrast
MRI Contrast Consent Form
CT Patient Safety Screening
Ultrasound Information Form
Sample Patient Billing Statement
See the sample billing statement area marked in yellow to help locate your code number and access code on your statement for paying your bill online.
We are very appreciative that you have allowed us to assist in your healthcare needs. We will strive to do everything in our power to make your visit with us comfortable and professional.
As you check in, please note, we will collect any copays or deductibles that may be due. Cash, check, and credit card are all accepted. 100% payment of copay or deductible is expected at time of service. If you qualify, a payment plan can be established if you cannot pay 100% at the time of service. A receipt is always provided.
For future reference, it is very important that patients make their scheduled appointment times, for their benefit and the benefit of others on the schedule. If you cannot make your scheduled appointment, please notify the office at least 24 hours in advance, to give us an opportunity to adjust our schedule. Missing an appointment and not calling to inform us could lead to a no-show fee.
Please take time to fill out a satisfaction survey to help tell us how we are doing. We appreciate your feedback to help us better serve you!
Thank you again for visiting us!
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