Interpretation of Your Films:
- Consent and Billing Formcompleted by patient and/or your office staff.
- Interpretation Request Formcompleted by doctor.
- Place films, Consent and Billing Form, and Interpretation Request into mailing jacket and place into mail. Or films may be mailed, then fax Consent and Interpretation Request Forms to us.
- Your patient or insurance will be billed. Service charges must be paid within 45 days from date of service.
Performing Examination on Your Patient:
- Examination Request Form completed by doctor.
- Fax or mail Examination Request Form to us.
- We will call patient to schedule, or the patient may call us at your discretion.
- Examination performed. Please verify your female patient is not currently pregnant or attempting pregnancy.
- Films and jacket hand-carried by patient or mailed back to referring doctor.
- Your office will be billed. Service charges must be paid within 30 days of date of service.
The following forms and useful documents are in Adobe Acrobat; they require the free Acrobat Reader to view. Click on each to download and view.
|Examination Request Form|
|Informed Consent and Billing Form|
|Interpretation Request Form|
|Radiology Fee Schedule|