Manchester Appointment Booking

Please use this secure form to make a booking for yourself as a referred or self-referred patient:

Referred patients can upload their referral letter and choose to pay with private medical insurance or self-pay. NHS referred patients with pre-agreed individual funding requests can also book.
Self-referred patients can book on a self-pay basis only.

On receipt of your booking form our admin team will contact you to offer suitable dates and times and take a deposit to secure your appointment. You will also receive an email copy of your booking form, please check your junk folder if you don’t receive it within a few minutes.

Start your booking by selecting the scan you require in the drop down menu below, if you’re not sure which scan type you need please see our comprehensive range of MRI scan descriptions.

Body area/MRI Scan type*

Your Details

Please fill in as many fields as possible making sure you have filled in the mandatory fields highlighted with an*

Title*

Name*

Email*

Confirm email address*

Preferred Contact Number*

Date of Birth*

Height*

Weight*

Address*

Town

County

Postcode*

Gender*

Male

Female

Mobility*

Mobile

Non-mobile

Pregnant*

Yes

Referral and Payment

Are you referring yourself?

Are you being referred by a healthcare professional?

Healthcare Practitioner Details

It is a requirement that we communicate results to a doctor or responsible health professional so that they can make recommendations about your future care. By completing this form you acknowledge that a copy of your report will be sent to your GP or responsible health professional. Additionally, neither the centre nor the reporting Radiologist is able to discuss the findings of the scan directly with the patient. By submitting this form you acknowledge that any and all enquiries regarding the content of the report and recommendations (if any) must be conducted with your GP or responsible health professional.

Title*

Name*

Email address

Telephone Number*

Practice / Hospital*

Address*

Town

County

Postcode*

Need assistance to fill out the form or would rather speak to a member of the team? We are here to help – please choose from the following options:

London +44 20 73706003 Manchester +44 161 4348039

Manchester Appointment Booking

Your Details

Referral and Payment

Healthcare Practitioner Details

Safety check

Relevant clinical details