MRI Ordering Guidelines

Electronic Referrals

Using electronic referrals to improve access to care is a priority within the government’s Action for Health Plan and has been adopted as Nova Scotia’s standard for managing and coordinating referrals for surgical consults and diagnostic imaging (DI) services. Currently, only primary care providers and surgeons are impacted at this time. Diagnostic Imaging went live with MRI on September 27, 2023 and ultrasound on December 6, 2023.

Following a period of transition and enhancements for primary care providers and surgeons, we are now further expanding user supports and making eReferrals use mandatory effective April 1, 2024.

Additional information can be found on the Nova Scotia eReferral Resource Hub at

Referral and Triage Process

To refer a patient for an MRI study, a standard MRI requisition must be completed by an authorized prescriber.

Primary care providers and surgeons are expected to use the eReferral tool to submit MRI requisitions. Services and specialties outside of primary care and surgery are to continue sending MRI referrals via fax to the site of the patient's choice.

All requests for MRI services are screened by a local radiologist for appropriateness and triaged according to level of urgency. Please refer to the Canadian Association of Radiologists Diagnostic Imaging Referral Guidelines (2012) for appropriate indications (

Any requisition without detailed clinical information will be returned to the requesting physician. On reviewing the requisition, the radiologist may:

  • return the request as not indicated,
  • return the request for more information, or
  • suggest or book an alternate investigation.

Primary care providers and surgeons using the eReferral tool can decline requisitions within the application and direct message providers for additional information. If you are a referring provider using the eReferral tool to send an MRI requisition, remember to check for messages from the diagnostic imagining site regularly as there may be a request for further information.

Clinicians using fax-based referrals are asked to send requisitions to only one hospital, as simultaneous requests to multiple hospitals block openings and contribute to longer wait times. The eReferral tool eliminates redundant work and promotes efficient use of time and resources by directing one referral to the patient’s preferred site, which in time, will help reduce wait times across the province.

MRI Safety

Some patients cannot safely undergo MRI because they have metallic foreign bodies in the eye or certain implanted medical devices in their bodies. It is very important to fill out the safety information on the MRI requisition. Many implanted medical devices can safely enter the MRI environment.