Appointment Request

REQUEST AN APPOINTMENT ONLINE

Scheduling your appointment is easy using our appointment request form below.  Simply complete the form below and submit.  One of our representatives will call you back within 2-3 business days to schedule your appointment. 

OUR SCHEDULING DEPARTMENT IS OPEN MONDAY - FRIDAY, 8:00 AM TO 5:00 PM.
PLEASE NOTE X-RAY EXAMS ARE PERFORMED ON A WALK-IN BASIS AND DO NOT REQUIRE AN APPOINTMENT.  

 

Appointment Request Form

Name(*)
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Phone Number(*)
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Email Address
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Date of Birth(*)
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Insurance Provider(*)
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Patient Status(*)
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Provider who referred you for this exam(*)
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Procedure Type(*)
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Preferred Day(*)
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Preferred Time of Day(*)
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Additional Comments/ Information
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If you need further assistance please email us at This email address is being protected from spambots. You need JavaScript enabled to view it..  If you prefer to speak directly with our one of our team members, please contact our Patient Care Center at 702-759-8600.

Call To Schedule An Appointment Today!

702-759-8600