Scheduling & Forms

All exams provided at Advanced Imaging Center require an order from a physician or health care provided with the exception of a screening mammogram. On occasion, a doctor will hand a patient the written order and ask the patient to schedule the appointment themselves. The patient needs to contact our office to set up the appointment. Advanced Imaging Center will try to accommodate walk-in appointments for most exams.

At the time of scheduling, the following information should be provided:

  • Patient name, address, phone number
  • Date of birth, social security number, and type of medical insurance
  • Is this a workers compensation, automobile accident, or third party liability case?

Advanced Imaging Center continues its dedication to provide the highest level in quality care and advanced technology to our referring doctors and their patients. Offices may contact our office to receive exam order pads and patient information brochures. If you need any further information or have any questions, please feel free to call us at (309) 743-0445.

  • Order Form
  • Automobile accident liability form
  • Worker's compensation form
  • Patient consent & assignment
  • Pre-Auth/Pre-Cert list


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