Radiology | Manhattan | New York City
Radiology | Manhattan | New York City Radiology | Manhattan | New York City

Forms & Information

Whether you are a new patient or an established one, you will be asked to fill out a questionnaire regarding your medical history. Please understand that if you have been here before, although we keep all of the information you have given us in the past and refer to it, it is very important that you give us a current update to many of the same questions. This information is critical for the interpretation of your exam.

If you have any special concerns or requests, please let us know as soon as possible so that we can help you efficiently. We will take all comments seriously and try to implement them whenever possible.

Patient Forms

We understand that your time is valuable. In order to expedite your registration process and to minimize your waiting period, it is advisable to print the relevant forms for your examination, fill them out by hand, and bring to Medical Imaging of Manhattan along with any previous films and reports you may have.

If you need clarification on any of the below mentioned forms, please contact us at (212) 794-2500.

To view the forms listed below, you will need Adobe Reader. You can download it for free at www.adobe.com.

Forms required for ALL procedures done at Medical Imaging

Form Required for any NEW patients

Breast Imaging Procedures

Ob/Gyn Procedures

Other Procedures

Medical Records Requests:

Methods of Payment

Medical Imaging of Manhattan is not a participant in any medical insurance plan. Payment is required on the day of the appointment upon completion of exams. You will be provided with an itemized statement and/or an insurance claim form to submit directly for your reimbursement. We accept all major credit cards, checks, or cash.

Please be advised, depending on the type of coverage you have, your insurance carrier may or may not acknowledge the claim. Although we will try to help you, we cannot be responsible for any reimbursements, or lack of, from your insurance group.

Medicare patients, please be advised that as of March 1st, 2010, Medical Imaging of Manhattan opted out of Medicare. For information on what this means for you, please click here.

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