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Most laboratory testing and X-rays do not need to be scheduled. Walk ins can be accommodated.

Only these laboratory and x-ray tests MUST be scheduled due to the process involved:

  • Glucose Tolerance test
  • Therapeutic Phlebotomy
  • X-rays that require a fluoro injections
Please complete the form below to schedule:
  • CT scans
  • MRI (Magnetic Resonance Imaging)
  • Ultrasounds
  • Nuclear Medicine Imaging
  • Outpatient Rehab (occupational, physical and speech therapy)
  • Family Birthplace Perinatal Testing
  • Pulmonary Function Testing and Blood Gases
  • Vascular Ultrasound

Scheduling Request Form

First Name Last Name MI



Daytime Phone                                   Evening Phone     
Date of Birth        
                             
SS # (Last 4)          
Best time to reach you?   

Where would you like to have your test?     
     

Ordering Physician (First & Last Name)

Type of Test

Diagnosis (reason for test or procedure)