PATIENT RESOURCES

Our imaging centers are modern, state-of-the-art imaging facilities conveniently located in the Southeast, designed to make diagnostic testing a much more pleasant and relaxing experience. We are committed to making your appointment experience very pleasant. Our patients can tell that we are there for them, from the reception area through the technologists and radiologist. Our hospital-quality imaging facilities are designed to make your experience as pleasant and relaxing as possible. We hope that you will choose us for your diagnostic imaging needs.

Please bring the following when you come for your visit:

• Driver’s License/Photo ID

• Completed Forms (See Patient Forms Below)

• Physician’s Order (If not already faxed to us by your physician)

• List of Medications

• Any Special Instructions

Southern Radiology Specialists now offers Health Screening for many common, life threatening medical conditions. Some may not be covered by your insurance company. However, these procedures are becoming recognized by the American College of Radiology and United States Department of Health as important in the detection and prevention of disease.

Health Screening Procedures

We have patient registration forms available below for your convenience. Feel free to fill them out and mail them to us prior to your appointment, or bring with you when you come for your visit. This will facilitate your appointment and get you back to your day as quick as possible.

Patient Information Sheet

Consent for Exam Which Includes Release of Info., etc.

Notice of Privacy Practice

• MRI Procedure Screening Form, No Contrast

• MRI Contrast Consent Form

• CT Patient Safety Screening

• Ultrasound Information Form

• Patient Survey

• Sample Patient Billing Statement

• See the sample billing statement area marked in yellow to help locate your code number and access code on your statement for paying your bill online.

We are very appreciative that you have allowed us to assist in your healthcare needs. We will strive to do everything in our power to make your visit with us comfortable and professional.

As you check in, please note, we will collect any copays or deductibles that may be due. Cash, check, and credit card are all accepted. 100% payment of copay or deductible is expected at time of service. If you qualify, a payment plan can be established if you cannot pay 100% at the time of service. A receipt is always provided.

For future reference, it is very important that patients make their scheduled appointment times, for their benefit and the benefit of others on the schedule. If you cannot make your scheduled appointment, please notify the office at least 24 hours in advance, to give us an opportunity to adjust our schedule. Missing an appointment and not calling to inform us could lead to a no-show fee.

Please take time to fill out a satisfaction survey to help tell us how we are doing. We appreciate your feedback to help us better serve you!

Thank you again for visiting us!

• Pay Your Bill Online