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Save time at our office by printing out the appropriate forms below, filling them out, and bringing them with you for your appointment.
   
 

Patient Information form — Please fill out if you are new to us or if you have not updated the form in the past 3 years
 
  Billing Policy notice — To be signed by ALL patients  
  Fill out this form if you had a prior imaging study elsewhere that we may need for comparison  
           (This form may be faxed to us or to the other facility.)  
  Fill out this form if you need us to send imaging studies to another facility  

FAX numbers for our three locations



For your information, please refer to our list of insurance plans with which we participate and our privacy policy.

   
  Select the test you will be having:
 
Mammogram Pelvic or Obstetric
Sonogram
Abdomen or Kidney
Sonogram
 
Thyroid Sonogram Osteoporosis DXA Test
 
 
 
Copyright 2004-17  Weinstein Imaging Associates, Pittsburgh, PA       North Hills 412-630-2649  •  Shadyside 412-441-1161  •  South Hills 412-440-6999
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