• Physician Referral (if known)
• MRI Results
• CT Results
• X-Ray Results
• Insurance Name, Phone, Subscriber Name, Policy Number
• Brief Hx of problem
• Imaging and Reports
• EMG Diagnostic Test
• Discogram Diagnostic Test
• X-Ray Diagnostic Test
• Plain CT Diagnostic Test
• CT Myleo Diagnostic Test
• MRI Diagnostic Test
• Primary Care Physician
• Physiatrist
• Pain Management Specialist
• Neurologist
• Neurosurgeon
• Orthopaedist