Schedule an Appointment
*Please note that the following form is to schedule outpatient imaging only.If you’re in need of a Covid-19 test please visit our Covid-19 Evaluation page to schedule online. For all other services, please call (219) 554-9911
Name
*
First Name
Last Name
Phone Number
*
Please enter a valid phone number.
Email
*
example@example.com
Service Needed
*
Appointment
*
Submit
Should be Empty:
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