Providing The Highest Quality Imaging In Nashville
Provides Inner Vision Women's Ultrasound with important patient information and allows us to set up your account with your contact and billing information. This form is also used for all updates to patient demographic information.
This consent educates the patient so that they may ask any questions prior to a sonohysterogram. All patients referred for a Sonohysterogram are required to review and sign this consent before services are performed.
BlueCross BlueShield of Tennessee acknowledgment of financial responsibility for the cost of services being provided.
Inner Vision Women's Ultrasound is happy to work with patients to provide a payment plan that will meet the financial needs of the patient within the guidelines as stated within the form.
Referral form to have an ultrasound examination performed at Inner Vision
To be completed by patients scheduled for an Amniocentesis prior to the procedure being performed.