Patient Exam Information

Patients - Please bring the following to your exam:

Photo ID. All patients must have idententification for verificaiton.  Minors will need to be verified by their parent or guardian.

Insurance card. Please bring your insurance card or evidence of insurance. If your insurance carrier requires a referral form, please bring it with you to your appointment or verify this prior authorization has been obtained by Guilford or your referring provider. If you are covered by Medicare or Medicaid, please bring the appropriate card.

Treatment Consent Registration Form and Exam Questionaires.  

If this is your first visit to Guilford Radiology or it has been over a year since you were here, you will be asked to complete a Patient Registration Form.  You can print this and bring it with you or complete this when you get here. 

Some exams will require a brief medical history.  These patient history forms can be found below, printed and brought with you, you will be provided one to complete at registration or your technologist will complete this with you.

Medication list. We may need to reference what medications you are taking to help assure they are no contra-indicaitons to your exam.  This is especially relevant if your exam will require oral or IV contrast.  Please bring a list of all medications and dosages, including all over the counter medicines you are currently using.

X-rays/previous imaging studies and results. To assure the best results, our radiologists will review previous imaging studies performed on the area we are scanning.  If you have any relevant X-rays or other imaging performed at any office or hospital that could be used as a comparison, please bring them to your appointment. This includes mammograms.  We accept electronic PACS transfer from most area providers, please contact them and they can determine the best way to get these images and reports to us.  Contact us in advance and we are also happy to assist with this.

Form of Payment. You may be asked to pay for services not covered by insurance including co-pay, co-insurance and applicable deductibles. We do not accept cash, we accept check, Venmo, or major credit card (Visa, MasterCard, or Discover Card) if a payment is required.

Other information about your exam:

Guests. You may bring a family member or friend to accompany you to your procedure but this is not required for most exams.  Space can be limited in some exam rooms and depending on radiation exposure and associated regulations, they may not be able allowed in the exam room during the exam.  Guests are welcome to wait in our lobby during your exam.

Dress.  We want every patient comfortable during their exam.  Please wear comfortable, loose-fitting clothes. Avoid wearing jewelry or valuables.  Should you need to change, we have gowns, shorts, or pants available and can provide a place for you to securely store your valuables.  

Exam specifics.  Please review specific exam preparation information below for exam preparation and anything else you may need to bring. 

Entertainment We want your visit to be as pleasnat as possible, for you and your guests.  Although our goal is no waiting, occasionally there is a little time between patinets.  We have televsion in our lobby along with a variety of books and magazines.  You may want to bring a book, magazine, laptop or PAD – we offer free patient wi-fi throughout our facility.

Questions, please give us a call at 203-453-5123 and one of our patient care coordinators is available to answer any questions.

Exam Information

MRI Information

MRI Questionnaire

CT Cat Scan Information

CT Scan Questionnaire

CT Cardiac Calcification Score questionnaire

CT Lung Cancer Screening questionnaire

CT Sinus Questionnaire

CT Spine Questionnaire

Mammogram Information

Mammogram Questionnaire

Ultrasound Information

Fluoroscopy Information

Other Information

Contact us

M-F 7:30AM to 5PM
Sat. 8AM to Noon