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	1-800-628-1302

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REQUEST FOR FURTHER INFORMATION

Please send me the following information:

..	Examples of X-ray suite floor plans along with a 1/4"-1' scale plastic template
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	Examples of Office floor plans
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	Current Journal reprints supporting the medical necessity for Tomography
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	2005 Superbill containing both diagnostic and treatment AMA/CPT codes
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Examples of Radiology Reports for:
	TMJ . . . Dental Implants
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	Regional Imaging Comparative Cost Analysis - for use in determining what Imaging fees are reasonable and customary for your region
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	Examples of representative X-rays from the Panorex CMT® X-ray System
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	2005 "Excellence in TMJ and Cephalometric Radiology" Seminar schedule

Marketing Assistance for:
	Private Imaging Center		Dental X-ray Lab

I am interested in:
	Leasing		Bank financing		Purchasing

My time frame is:
	6 mo.		1 yr.		2 yr.		Other

	Please Call me regarding purchasing/leasing a Panorex CMT®/CMT Plus
.
	I am not interested in Tomography Equipment at this time.

Please call me regarding technical assistance with our:
...		Film Processing
...		Transcranial Techniques
...		Panoramic Techniques
...		Tomographic Techniques
...		Cephalometric Techniques
...		Physical Medicine Modalities

Please send me a Product Catalog

Other:

*Contact information (denotes required information)**
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* Doctor's Name:
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* Address:
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* City:		* State:	* Zip:
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* Email Address:
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* Telephone No.:
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Fax No.:

Imaging Systems, Inc. 111 Petrol Point Suites 100-103 Peachtree City, GA. 30269	info@imagingsystms.com	1-800-628-1302 1-770-631-9222 Fax 1-770-487-1514
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