Book Your Scan Today

Please complete the form below ensuring no field is kept blank. Once this is completed we will contact you within 12 hours to arrange your scan date and time. If you require a private GP and/or Physiotherapist Consultation prior to your scan, we can help arrange this at no additional cost within 24 hours.

Please note once we receive your referral, the request will be looked at by one of our Consultant Radiologist and/or Radiographers to ensure the correct imaging protocol is applied for your scan.

Appointments will be available within 1-2 days from your enquiry for MRI scans. You will receive the Consultant Radiologist written report within 48 hours from the scan taking place.

Please note availability for CT scans will be more limited and likely to be within 3-5 days.

Please make sure to include details of any previous imaging reports related to your symptoms.

Any files can be uploaded on our "file upload" option on this form.

Imaging Referral Form

First Name

Last Name

Date of Birth

Contact Number

Street Address

Post Code

City/Town

GP Name and Surgery Name

Please enter type scan and body area required.

Upload File

Please provide your clinical history and symptoms in mentioning the reason for requesting a scan so a specific imaging protocol can be applied for your scan appointment.

If you have a completed referral form already from your GP, Physiotherapist , Clinician, please send this to info@pro-scanimaging.com. Please note our Consultant Radiologist and/or radiographer will review your clinical history and symptoms to ensure an accurate imaging protocol is applied for your scan.

Please advise of your upcoming availability when you would like to be booked in for your scan.

I confirm I have read and accept the privacy Statement and consent to my information being used to contact me regarding my enquiry. *

I give permission for my Scan report to be shared with my GP for the purpose of my follow up. I also agree to follow up my scan report with my GP *