Sacramento Radiology Medical Group Forms
 

 

Referring Physicians- Ordering referral pads, patient brochures, case studies, etc., can be ordered right from your computer!

Simply complete the information request form and click"Send Request."

Your request will be processed and completed within 24 hours. Or, if you prefer to telephone in your request, please call (916) 363-3317, ext. 281.

New Patients
If you are a new patient, please print and complete the form below and bring it to your first appointment.

Download Here: NEW PATIENT FORM

HIPPA: Our Commitment to Your Privacy
In accordance with the Privacy Regulations created by the Health Insurance Portability and Accountability Act of 1996 (HIPAA), we are required to maintain the confidentiality of your health information and to provide you with a copy of this notice. We realize that these laws are complicated, but we must provide you with the following important information which describes how we may use and disclose your protected health information to carry out treatment, payment or health care operations; and for other purposes that are permitted or required by law. It also describes your rights to access and control your protected health information. "Protected health information" is information about you, including demographic information, that may identify you and that relates to your past, present or future physical or mental health and related health care services. The physicians and staff of Sacramento Radiology are dedicated to maintaining the privacy of your health information.

If you have any questions about this notice, please contact:

William R. Johnston, Chief Operating Officer
3291 Ramos Circle, Sacramento, CA 95827
Email: bjohnston@sacrad.com

Each of the files above are saved in PDF format and require Adobe Acrobat Reader. Adobe Acrobat Reader is available for free. Click here to download Acrobat Reader.
   

 


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