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Sand Lake Imaging – Radiology Centers -
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Patient Forms

Authorization to Release Information
Autorización para Divulgar Información
HIPAA Authorization
HIPPAA Autorización
Breast History Form
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Medical History Questionnaire

Thyroid Ultrasound Packet

Thyroid Ultrasound / Chest X-ray
Assignment of Benefits

X-ray Packet

Thyroid Ultrasound / Chest X-ray
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Colonoscopy Packet

Colonoscopy
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PET Scan

PET Scan
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Breast MRI For New Patients

Patient Information Form
Breast History Form
Breast Cancer Risk Assessment Tool Form
Release Of Confidential Information Form
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Dexa Scan

Bone Density Form
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General MRI or CT

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CT MRI Brain Form
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Pre-Procedure Responsibility Form – Information for Parents*
*For Pediatric MRI Sedation

Mammograms

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Services & Procedures

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  • Woman's Imaging & Screening
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      • Breast Biopsy
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      • Ultrasound
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    • Heart and Vascular Health
      • Coronary Calcium Scoring
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    • Interventional Radiology Overview
    • Aspiration of the Body
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    • CT Arthrogram
    • Ultrasound Aspiration Biopsy of the Thyroid
  • Diagnostic Imaging
    • Diagnostic Imaging Overview
    • 3T Magnetic Resonance Imaging (MRI)
      • Breast MRI
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    • 64-Slice CT Scan
      • Coronary Calcium Scoring
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      • PET CT
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      • Nuchal Translucency Screening Test
      • Ultrasound Aspiration Biopsy of the Thyroid
      • Ultrasound Guided Breast Biopsy
      • Vascular Ultrasound
  • Nuclear Medicine

Important Information

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“I’ve had nothing but respected and friendly service here. The team is really caring and they try to comfort you in every way they can. I have done a mammogram, CT, MRI and Xray here throughout the last 2 years and I am pleased to give them 5 stars.”

Christine B.

Read More Reviews Here
3 Convenient Locations to Serve Your Radiology Needs:
sli-lady-lake Lady Lake and The Villages (352) 753-2660 (352) 753-2660
sli-orlando Orlando at Dr. Phillips (407) 363-2772 (407) 363-2772
sli-maitland Maitland, Florida (407) 363-2772 (407) 363-2772

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Services

  • Diagnostic Imaging
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Our Locations

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  • Orlando
  • Lady Lake
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© 2019 Sand Lake Imaging, PLLC

 
mri accredited facility
pet accredited facility
ultrasound accredited facility 
breast mri accredited facility
nuclear medicine accredited facility
unsure accredited facility
acr lung cancer screening
ct accredited facility
breast ultrasound accredited facility
acr mamography
 
 
yale university
harvard university
university of miami
duke university
cornell university
 

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