This page contains form/s that are intended to be paper based that you can download and complete. If you are using any assistive technology and are unable to use the form please contact us using the enquiries form.
Description of Medical ServiceMagnetic Resonance Imaging (MRI) to image the liver. MRI utilises strong, uniform magnetic fields to investigate the anatomy, perfusion, tissue characterisation and function of different organs and systems within the human body.
Description of Medical ConditionColorectal carcinoma (CRC) with suspected liver malignancy requiring characterisation, or suspected hepatocellular carcinoma (HCC)
Reason for ApplicationNew MBS item
Medical Service TypeInvestigative medical service
Previous Application Number1372
Application Form1372.1 Application Form (PDF 257 KB)
1372.1 Application Form (Word 551 KB)
Consultation SurveyConsultation Survey (PDF 99 KB)
Consultation Survey (Word 508 KB)
PICO ConfirmationPICO Confirmation (Word 866 KB)
PICO Confirmation (PDF 1119 KB)