V12_July_7_2023 fixed bug with second page not showing up after printing only page 1.
V11_June_15_2023 email input changed to "text" from "email" so it will retain information, added ids to inputs so they will retain information, renamed duplicate names to avoid information confusion; JohnR
V10_Oct16_2022 has the Tickler Loop Closer to ensure the request has been completed by user-specified time.
2021-May-15 16:39 Updated to remove PrintSubmit combo which has proven problematic. Measurement observed dates have time stamp removed. Fax number is copyable for pasting to eFax. Unnecessary references trimmed.
Update 2020-Mar-30 08:09 - Mostly revisions to the second page. As of October 29th 2018, everyone in the Lower Mainland of BC is supposed to be using this form to book MRIs. Thanks to JohnY for working tirelessly on this. Annotation is as follows: The original background had yellow highlights that, unfortunately, print very dark, and fax even darker, making the labels all but useless. Corrected in V6_Nov24_2018
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MRI_LM_central_V12_Jul7_2023.zip | Download |