Request a 30-day pilot

Tell us a little about your imaging department. Within 1 to 2 business days, we will email a short pilot agreement for you to review and sign electronically. There is no cost during the capped 30-day pilot and no obligation to buy. Please do not enter any patient information on this form.

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Your facility

Facility name *

Health system (optional)

Street address *

City *

State *

2 letters, for example FL

ZIP code *

About you

Your name *

Your title *

Work email *

Work phone *

We use your phone number only to respond to your request. We do not send marketing texts.

Best time to reach you (optional)

Who signs agreements for your department?

We will send the pilot agreement to this person. If it is you, enter your own details.

Signer's name *

Signer's title *

Signer's email *

Modalities to include *

Check at least one.

X-ray CT MRI Ultrasound Nuclear Medicine PET/CT Mammography Fluoroscopy DEXA Interventional

Your department

About how many outpatient exams per month? *

Scheduling system *

Preferred pilot start month *

How did you hear about us? (optional)

Comments (optional)

Please do not include patient information.

I agree to the Terms & Conditions and Privacy Policy. *

Required

Thank you. We received your request.

Within 1 to 2 business days, Dennis Love will email the pilot agreement to the signer you listed, for review and electronic signature. There is no obligation to buy.

Questions? Email dennis@imreadytoscan.com or call (772) 202-8841.

Patient preparation that protects imaging capacity, scheduler time, and the care experience.

Request Pilot