MRN 3T Scan Credit Request Form

Please complete this request form to add Scan Credits to your PI Account for the MRN 3T MRI Scanner. Scan Credits are issued in 30 minute increments. Scan Credits can be requested at any time during the month. Scan Credits do not guarantee a spot on the Trio Reserved Calendar, however, Scan Credits need to be purchased before scheduling time on the 3T. Scan Credits expire 30 days after the effective date that you set on this request form. Your account will be billed only after a Scan Credit has expired.

To request a reserved slot on the Trio Reserved Calendar please contact This e-mail address is being protected from spambots. You need JavaScript enabled to view it
Please contact This e-mail address is being protected from spambots. You need JavaScript enabled to view it if you have any questions about Scan Credits.

 

* Required

(Format: First Name Last Name) 

(Format: 00-000) 


(Format: 0000-000) 

30 minutes per Scan Credit; This is the number of Scan Credits that the PI will be charged for. The funding source actually charged will be based on actual usage at the end of the month, as per the Service Center Policy.




(Scan Credits expire 30 days after Effective Date)