Request Appointment
Request Appointment

    Our Hamilton and Lawrenceville locations accept walk-in x-ray patients. Walk-in hours can be found on our locations page.

    Patient Information





    *Gender
    *Date of Birth

    Under Age Agreement

    Based on your answer for the patient's Date of Birth, you have indicated that you or the patient is not an adult (18 years of age or older). A parent or guardian will need to be present with you or the patient at the time of the requested appointment. Please indicate you understand our Under Age Agreement by providing your answer below.

    Under Age Agreement*

    Referring Physician Information

    Calcium Score Patients – a prescription from your physician is not required for this exam.

     

    *Referring Physician
    Upload Prescription
    (acceptable file types are pdf, png, jpg or jpeg)

    Insurance Information

    *Insurance Provider
    *Policy Number

    Appointment Information

    At this time certain procedures are only available at select locations. Please view them below.

     

    Hamilton Facility

    Lawrenceville Facility

    Urogram

    Calcium Scoring

    Extremity MRI

    Breast MRI

     

    *Requested Location
    *Requested Date
    *Preferred Time

    Procedure Information

    *Requested Procedure

    Body Part (For an MRI/MRA, Extremity MRI, CAT scans, CTA, Arthogram and Ultrasound let us know the specific body part for the procedure.)
    Any additional information you need to provide?

    RAI Radiology Affiliates Imaging

    Radiology Affiliates Imaging offers highly specialized experience in every facet of radiology, utilizing current and progressive protocols with the most innovative techniques for diagnostic imaging and therapeutic intervention.