PATIENT INFORMATION

Insurance Information:

SMDI participates in virtually all insurance plans. SMDI bills globally for all but echocardiograms, meaning there is only one fee; the technical and professional reading fees are included in the quote. Our personnel are available to assist you with any questions you may have.

Click here to request more information or call (352) 628-9900.

Click here to view SMDI’s current provider list

Patient Forms:

Want to save time on filling out forms when you arrive for your appointment? You can now download, print and fill out patient forms before you get to our office. Just bring the doctor’s prescription, registration paperwork, insurance card, and photo ID.

Please click on the link below to download your form.

SMDI Registration
SMDI Patient information
SMDI Request for outside films
Assignment of Benefits
MRI Questionaire
CT Pregnancy Consent
IV-CT Consent-History

Have you had a previous exam that the radiologist can use for comparison? Download and complete the permission form to allow SMDI access to those records. Bring the form with you to your appointment.

SMDI Request for pickup of images & reports (fax to 352 628-9700)

Hippa Notice of Privacy Practices

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