MediServices Healthcare Ltd.
  • Login
  • Patient Information
    • Video Telemetry – What to Expect
    • Sleep-Deprived EEG – What to Expect
    • EEG Test – What to Expect
    • Ambulatory EEG – What to Expect
    • EMG and NCS – What to Expect
    • Non-Obstetric Ultrasound (NOUS) Scan – What to Expect
  • Careers
  • About Us
    • Our Clinical Governance
    • Compliance Procedure
    • Our Board
    • Our Clinicians
    • Social Value
  • Case Studies
  • Services
    • Neurophysiology
      • Electromyography (EMG)
      • Electroencephalogram (EEG)
      • Sleep Deprived EEG
      • Ambulatory EEG
      • Video Telemetry
    • Intraoperative Neuro Monitoring (IONM)
      • Cranial
      • Spinal
    • Non-Obstetric Ultrasound (NOUS) Services
  • Working With Us
    • Hospitals
    • Join Us
  • News
  • Contact
Iom 4

IOM Referral Form

DD slash MM slash YYYY
Time of Surgery(Required)
:
MM slash DD slash YYYY

Monitoring Info

Type of Surgery (Please choose one)(Required)
Required Monitoring
Cranial Nerves III-XII

Requester Information

Requester Name(Required)

Clinical Governance

MediServices Healthcare continuously strives to uphold an excellent standard of service.

Led by our Non-Executive Director – Governance, our clinical governance committee ensures that the quality of all services is continually monitored and reviewed.

Image
Image (1)
Image (2)
Image (3)
Image (4)
MediServices Healthcare Ltd.

Leading Experts in Neurophysiology and Specialist Diagnostics

Greenlands Business Centre, Studley Rd, Redditch B98 7HD

020 3868 6249

bookings@mediservices.healthcare

Useful Links

  • Case Studies
  • Contact
  • Patient Information
  • Careers

Legal Policies

  • Privacy Policy
  • Carbon Reduction Plan
  • Modern Slavery Statement
  • Cookie Policy
© 2026 MediServices Healthcare Ltd.Website by XIST2
  • About Us
    • Our Clinical Governance
    • Compliance Procedure
    • Our Board
    • Our Clinicians
    • Social Value
  • Case Studies
  • Services
    • Neurophysiology
      • Electromyography (EMG)
      • Electroencephalogram (EEG)
      • Sleep Deprived EEG
      • Ambulatory EEG
      • Video Telemetry
    • Intraoperative Neuro Monitoring (IONM)
      • Cranial
      • Spinal
    • Non-Obstetric Ultrasound (NOUS) Services
  • Working With Us
    • Hospitals
    • Join Us
  • News
  • Contact
  • Login
  • Patient Information
    • Video Telemetry – What to Expect
    • Sleep-Deprived EEG – What to Expect
    • EEG Test – What to Expect
    • Ambulatory EEG – What to Expect
    • EMG and NCS – What to Expect
    • Non-Obstetric Ultrasound (NOUS) Scan – What to Expect
  • Careers
Manage Consent
To provide the best experiences, we use technologies like cookies to store and/or access device information. Consenting to these technologies will allow us to process data such as browsing behaviour or unique IDs on this site. Not consenting or withdrawing consent, may adversely affect certain features and functions.
Functional Always active
The technical storage or access is strictly necessary for the legitimate purpose of enabling the use of a specific service explicitly requested by the subscriber or user, or for the sole purpose of carrying out the transmission of a communication over an electronic communications network.
Preferences
The technical storage or access is necessary for the legitimate purpose of storing preferences that are not requested by the subscriber or user.
Statistics
The technical storage or access that is used exclusively for statistical purposes. The technical storage or access that is used exclusively for anonymous statistical purposes. Without a subpoena, voluntary compliance on the part of your Internet Service Provider, or additional records from a third party, information stored or retrieved for this purpose alone cannot usually be used to identify you.
Marketing
The technical storage or access is required to create user profiles to send advertising, or to track the user on a website or across several websites for similar marketing purposes.
  • Manage options
  • Manage services
  • Manage {vendor_count} vendors
  • Read more about these purposes
View preferences
  • {title}
  • {title}
  • {title}