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Outpatient Imaging Request Form

Imaging Modality
Contrast Injection Required
CBC & Chemistry completed
Chest rads performed?
Upload X-Ray Here
Upload Additional X-Ray Here
Upload Medical Records Here
Upload Bloodwork Results Here

Typical turnaround time for interpretation is 24 business hours. Should you require more urgent interpretation; please contact us prior to the appointment so that we can make the necessary arrangements.

Thank you for requesting an outpatient imaging study with the VSCAN!

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