Scheduling

If your physician is sending you to Crouse Hospital for a service or procedure in Medical Imaging, his/her office usually will schedule the appointment for you. However, if you need to schedule or change your appointment, complete and submit the form below to request a time convenient for you. Or, call the scheduling department at 315-470-5880.

Home » Services » Imaging Services » Scheduling

Schedule an appointment using the form below.

Name*
First Last
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code
Date of Birth*
MM slash DD slash YYYY
Email*
Primary Phone*
Work Phone
Referring Physician
This request is for (select all that apply)
- Digital Fluoroscopy
- Diagnostic Radiology (X-ray)
- Magnetic Resonance Imaging (MRI)
- Computed Tomography (CT/CAT Scan)
- Computed Topographic Angiography (CTA)
- Ultrasound (Sonogram) Nuclear Medicine Mammography/Breast Care Services
- DEXA/Bone Densitometry Interventional Radiology
- Peripheral Vascular Intervention
Select month of desired appointment*
Select preferred day of the week*
Time Preferred*

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