EMR Request Form
Imaging Specialists is now offering paperless faxing directly to your EMR files.
Please fill out this form to receive your patient reports to your EMR files.

Please provide us with the following information:

Practice Name:
Address:
Email:
Phone:
Please list all Physicians in your practice:
INTERNAL FAX NUMBER:
(please note *this number is different from your general fax number and is REQUIRED to receive reports into your EMR files)
You will receive confirmation that set-up is complete. How do you wish to be contacted?
Email Phone

Our state of the art open 3T MRI is the second of its kind in the country.

 

 

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