Complimentary MRI Review & Priority Scheduling

Complimentary MRI Review & Priority Scheduling
At Seaside Spine Specialists we realize that not every pain is the same. There are many patients that have acute and severe pain that might be the result of a new disk herniation or even a fracture. For those patients we would like to reserve a spot at the front of the line. We call this priority scheduling, and we offer it to our current and potential patients that are in acute pain and have had a recent MRI. The MRI imaging allows us to quickly identify the pain generator and offer you a more immediate treatment option. As always, we start with the least invasive intervention that is most likely to benefit you.

If you have had a recent MRI of the spine and believe that you are a candidate for priority scheduling, please complete the form below. A Seaside Spine Specialists team member will reach out to you soon and get you started on your journey to getting better.

If you are currently being offered surgery then you should strongly consider a complimentary MRI review by one of our Board Certified Neurosurgeon who specialize in minimally invasive and robotic spine surgery. We feel confident that your second opinion is likely to become your first choice.
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First NameLast Name
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Date of Birth:*

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Date
What state do you live in?*
Can you briefly describe your condition to us? Specifically describe any neck pain, low back pain or pain/numbness or weakness in the upper extremities.
I am using my phone/tabletI am using my computer
Tap here to take a photo of the FRONT of your PRIMARY insurance card.*

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Tap here to take a photo of the BACK of your PRIMARY insurance card.

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I would like to manually type in my insurance card information.I have a scanned copy of my card and I would like to upload that file.
Please type your insurance card information below.*
Please upload you insurance card information here.*

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Who is your primary care doctor?
How many cervical (neck) surgeries have you had?
How many lumbar (low back) surgeries have you had?
Medical University of South Carolina (MUSC)Trident Medical Center (TMC)Summerville Medical Center (SMC)Colleton Medical Center (CMC)Roper Downtown CharlestonRoper St. FrancesRoper BerekelyRoper Mt PleasantEast Cooper Medical Center (ECMC)Beaufort Memorial Hospital (BMH)Tricounty RadiologyImaging SpecialistsAxis 3T MRIAmerican Health ImagingPalmetto Primary Care Diagnostic Imaging CenterMRI of Charleston (Pain Specialists of Charleston)Low Country Orthopaedics**NO, MY MRI WAS DONE SOMEWHERE ELSE**
YesNo
If you selected 'NO,' then you have three options for getting us your imaging. No need to complete this now. These instructions will be emailed to you once you submit the form.

First you will need to call or visit the imaging center and ask them to put your imaging on a CD. Then you can do any one of the following:

1. Mail us the MRI CD:

Seaside Spine Specialists

9565 Highway 78, Building 100

Ladson, SC 29456

2. If you have a CD reader on your home computer, then follow these instructions:

Upload your MRI CD from home by clicking this link:

Seaside Spine MRI CD Uploader

3. If you do NOT have a CD reader on your home computer, then follow these instructions:

Upload your MRI CD from your local CVS:

Take your CD to the Photo Kiosk at any CVS.

Click on the screen and select "My Medical Images."

Create a free account.

Click the option that says "Share images with my Doctor."

Then, when prompted, type in Seaside1 to select our practice as the destination for your imaging files. You will get your CD back once the files are uploaded.
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Since you are using a phone/tablet, it would be easiest to take a picture of the report? Click here to take a photo of page #1.

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Click here to take a photo of page #2.

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Click here to take a photo of page #3 (if you have a third page).

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Since you are using a computer, it would be easiest to upload the file here:

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Seaside Spine Specialists offers MRI reviews to potential patients. The act of submitting medical imaging does not create a patient-physician treatment relationship. Once submitted, our expert medical team will review your scans. After our review, our office may contact you to discuss the results via telephone. At that time, our medical team will discuss your options, whether surgical or nonsurgical. By sharing your medical images, you acknowledge and agree to the following: 1. That your personally identifiable health care information can be shared with employees of Seaside Spine Specialists. 2. That the image review is providing only an informational review of the documents that you are providing and does not create nor constitute a physician patient relationship. 3. That the information provided by our providers is not a form of diagnosis. A diagnosis can only be made if you have been physically examined by a Seaside Spine Specialists’ provider. Upon receipt of your medical images, Seaside Spine Specialists will NOT share your personally identifiable health care information with third parties without your written consent.
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