with select ValleyMedical Group doctors
Please use the form below to request an appointment at
Valley Hospital's Diagnostic Imaging Department or Breast Center. A physician's
prescription is needed for all tests at Valley Hospital and you will need to bring
it with you. All fields with a red asterisk are mandatory and must be completed
to submit your request. This form will be sent to a Diagnostic Imaging
Registrar at Valley Hospital who will call you back within one business day to confirm
a date and time with you. Our Registrars receive Internet inquiries and will place
phone calls between 8:30 a.m. and 4:30 p.m., Monday through Friday.
Valley considers the information you provide as confidential and it will not be
shared with any third parties. All submissions will receive an automatic e-mail
informing you that we have received your information.
Please contact your doctor if you have any questions about the prescription for
your test. Some procedures require pre-authorization from your insurer. Please check
with your insurance company.
If you would prefer to make an appointment by telephone, please call us at 201-447-8422. For PET Scan appointments, call 201-634-5738.
Thank you for choosing The Valley Hospital.
* To move from one field to the next in this form, please use the Tab key.
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