AMRI-NC: Advanced Magnetic Research Institute of North Carolina, LLC.
AMRI-NC
Advanced Magnetic Research Institute of North Carolina, LLC
 

Patient Needs Analysis

* = Required
* Your Name
(select one)
Address
City
State
Zip
Phone
Fax
* Email
Patient Name
Age
Principal Complaint
Is Patient Ambulatory?
Requested Treatment Dates
Therapeutic Services Requested:
please check the services in which you are interested:


Special Services Requested:
please check the services in which you are interested:




Insurance Information:
Note: MME treatment is not covered by insurance.
See financial policy for details
Carrier Name
Contact Phone
Group #
Policyholder
Employer
Submit 


 

AMRI of North Carolina was founded to offer MME treatment under the guidelines of an Investigational Review Board consistent with FDA regulation. Please note that MME treatment is considered to be experimental by the FDA. Although many patients have achieved their treatment goals, no guarantee of success is implied.

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