Schedule an Exam at SDI

SDI Diagnostic Imaging Online Scheduling makes scheduling an exam even easier. Our staff is available to schedule an exam for you from 7:00 AM to 6:00 PM, Monday through Friday.

To have a SDI scheduling representative call you within the hour, please complete and submit the form below. Our scheduling representatives will review the form and call you to confirm the details and schedule your appointment.

If you would prefer to speak with a scheduling representative now, please call 813-348-6988.

Interested in printing prescription forms, please click one of the following: General, Gyn, Interventional

* Indicates Required Field
Today's Date:* Required
Patient's Name:* Required
Address:
City:
State/Province:
Zip/Postal Code:
Home Phone:* Required
Cell Phone:
Email Address: Invalid Email
Insurance Information
Primary Insurance:
Policy #:
Group #:
Phone #(Inc):
Subscriber(Policy Holder Name):
Policy Holders Date of Birth:
Policy Holders Social Security #:
If policy holder is someone other than patient: Relationship to Patient
Auto/Workers Comp Section (Only Fill out if Applicable)
Is this auto related?:	Yes No
If yes, Date of Accident
Claim #:
Is this work comp?:	Yes No
If yes, Date of Injury
Claim #:
Adjusters Name?:
Adjusters Telephone #
Claim Address?:
Claim City
Claim State?:
Select "location", "exam type", "date" & "time" from below. Please note that these fields are mandatory.
Location:*Required	- Select Location - - Armenia - - Oldsmar - - South Tampa -
Exam Type:*Required	- Select location above -
Date?:*Required
Time?:*Required	AM   PM
Comments
Please read the below form.
Notice of Privacy Rules
The below form needs to be filled and signed. Please bring this form with you on your next appointment.
HIPAA Form