Imaging Appointment Scheduling

Please upload your imaging order below. In most cases, an imaging order is used to determine available scheduling options.

If your imaging appointment does not require an order, such as a screening mammogram or heart scan, please select No.

For questions, please call 346.356.3044 from 8 a.m. – 5:30 p.m., Monday – Friday.

*denotes required field

Do you have an imaging order from your doctor? * Yes, I have an imaging order and will upload it now. No, I do not have an imaging order, or I do not wish to upload at this time.

Patient Full Name * Patient Date of Birth (MM/DD/YYYY) * Patient Phone Number Patient Email Address Attach imaging order document/picture (PDF, JPG or PNG files only) * Optional: Attach a second document/picture (PDF, JPG or PNG files only)

I do not have an imaging order. Or, I have an imaging order and agree to email or text my order after the scheduling process; I understand this is an extra step after scheduling. * I agree

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Imaging Appointment Scheduling

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