If your treating physician has not ordered a diagnostic test [MRI, CT, EMG]:

•  Keep this on file with your other case paperwork. If at any time your physician requests a diagnostic test you can provide them with this notice.  

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If your treating physician has ordered or plans to order a diagnostic test [MRI, CT, EMG]  and:

• A)    you have a copy of the script:

  • Submit below or email to referrals@jagsource.com [or by fax to (518) 252-3437] and a member of our team will contact you to get scheduled at a location convenient to you.  

• B)    you don’t have a copy of the script:

  • Submit a copy of the form below and a member of our team can follow up with your physician to get a copy.

• C)    You are waiting to see your physician to have a test ordered

  •  Bring this document with you and let your physician know that you would like to get scheduled through JAG Source.​

If your questions have not been answered here, please submit the form below with your inquiry and a member of our team will be in touch!