How to Schedule a New Patient
APPOINTMENT
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CALL Digital Motion Imaging to schedule your patients for Digital Motion X-Ray.
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It is very important to confirm this appointment with your patient 48 hours in advance. This
will allow your office to provide Digital Motion Imaging 24 hours notice of all cancellations.
FORMS
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Please fill out the Verification Log
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Please have referring clinician fill out Prescription Form indicating:
• the history of the patient’s injury,
• the study(s) to be performed,
• medical necessity,
• method of receipt, and
• clinician signature.
PROCESSING
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FAX the completed signed Prescription Page and Verification Log to (530)226-9407
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On the day of testing, have the patient bring the following:
• Prescription Order
• Full Payment for Services
• Drivers License or Current ID -
KEEP a copy of the Prescription page on file for your documentation.
PAYMENT OPTIONS
• Cash
• Personal Check
• VISA, MasterCard, Debit
• 12 month, Interest Free Financing through Unicorn Financial
For online pre-approval go click the Unicorn Image above.
TYPE IN ID# 70066, then CLICK on “Submit” button
FILL IN the “Applicant Information,”
CHECK the “I Agree” Box, and then CLICK on “Submit Now.”
• Receipt of Services and Special Report will be given to aid in insurance review.
