Call to Schedule Your Appointment
315-787-5399
Call to Schedule Your Appointment 315-787-5399

Patient Forms

 

For your convenience we have included printable Screening and Patient Information Forms, which are required to be completed the day of your exam.  We have also included our Financial Policy, as well as our Privacy Notice for you to review.   

 

Screening Form

Patient Information Form

Map and Directions

Financial Policy

Privacy Notice

 

Finger Lakes Radiology accepts the following insurances:

BC/BS, BC/BS Traditional, Blue Choice, Blue Choice Option, Department of Labor, Empire Plan, Fidelis, GHI, Humana, Magnacare/Aetna, Medicare, Med Risk/MDIA, Monroe Plan, MVP/Cigna, NYS Medicaid, Ontario County Public Heatlh, PHCS/Multiplan, POMCO, Railroad Medicare, RCIPA, RMSCA, Today's Options, Tricare, Tricare Prime, Tricare for Life, United Healthcare (secure Horizons, Medicare Complete, AARP, Evercare, American Progressive), US Imaging, Wellcare and WPS Health Insurance.

Co-payments are due at the time of service.

We appreciate a 24 hour cancellation notice.