Please install Flash® and turn on Javascript.

Tel: (626) 962-3525 / Toll-free: (877) 96-SGVDC (877-967-4832)

Business Hours

Monday - Friday: 8:00am -7:00pm & Saturday: 8:00am - 3:00pm

You may also fill in the fields below. A member of our staff will contact you within 1 business day.

I would like to request:

Referral Pads	An Appointment
Radiology CPT Code Guide	Copies of My Medical Records
Current Insurance List	Information re: your services
A Patient's Films	Online Reports (R.O.D)
A Patient's Report	Online Images/Films (PACS)

Name*

Address

City

State

Zip Code

Phone

Fax

E-Mail*

Type of Inquiry*

Questions & Comments:

Having a hard time reading? Move your mouse over the speaker...

IF THIS IS AN EMERGENCY OR URGENT REQUEST, PLEASE CALL OUR OFFICE (DO NOT USE THIS FORM).

Helpful Links
Print Ready Files

Referral Pads

Radiology CPT Code Easy Guide

Diagnosis & ICD-9 Code Easy Guide

Accepted Insurance Plans

Patient Paperwork

For Physicians

Online Reports Access

Online Reports Access Guide

Online Image Access (PACS)

Online Image Access Guide

Helpful LinksPrint Ready Files