Schedule An Appointment
To schedule any of our procedures, please call
317-XRAY-NOW (972-9669) or 800-400-XRAY (9729), option 2
from 8 a.m. – 5 p.m. Monday – Friday, or complete the form below.
No appointments are necessary for general diagnostic X-rays such as chest, spine, sinuses, extremities, ribs, etc.
Appointment Request Form
Appointment Scheduled by:
Date of Birth:
Primary Phone Number:
Secondary Phone Number:
Alternate Phone Number:
1st Choice Preferred Date:
2nd Choice Preferred Date:
Preferred Time for Appointment:
Type of Procedure:
-- Select A Procedure --
Bone Density/Osteoporosis Study, DEXA
Symptoms or Reason for Exam:
Please let us know if you have had previous mammography elsewhere.
If you can bring these films with you, this would be very helpful. Otherwise, we will be happy to request the outside mammogram by mail delivery.
If you need to cancel your appointment, we would greatly appreciate if you would provide 24 hours notice.
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