St. Thomas Radiology Associates, LLC
Yuri Peterkin, MD
Mahogany Ambrose, MD

MRI Referral Requisition

9149 Estate Thomas
Paragon Medical Building, Suite 103
St. Thomas, U.S. Virgin Islands 00802
Phone: (340) 774-0265 • Fax: (340) 776-0228
www.radiology.vi

Gender   
Extremity
MR Angiography

Other
Please note, cancer patients should have MRI of head/chest/abdomen/spine with and without contrast
  • Please report approximately 30 minutes prior to appointment time. NO Metal or jewelry can be worn in the machine.
  • Please bring X-rays or CT scans if you have them.
  • Please be sure to bring your insurance card and photo ID.
  • If you are unable to keep your appointment, please notify us 24 hours in advance, if possible.
  • The examination will take apporoximately 1 hour.
  • Patient MUST notify us if they have a pacemaker, glucose monitor, hearing aid or any implanted device at time of scheduling.
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