Request An Appointment
To request an appointment, please complete the form below. We'll contact you right away to schedule it and arrange any other details as necessary.
Patient Registration Form
To expedite your appointment, you may complete your Patient Registration Form prior to your arrival. Please download and print the PDF version of the Patient Registration Form by clicking on the link below.
PDF - Patient Registration Form (for general patients only)
PDF - Patient Registration Form (for varicose veins patients only)
You may also call us at 203-330-0248 to complete your Patient Registration Form by speaking with one of our staff members.
For Healthcare Professionals
If you are a healthcare professional looking to refer a patient to us, please download and complete our patient scheduling form. Completed forms can be emailed to firstname.lastname@example.org or faxed to 203-330-9730.
Scheduling Form For Dialysis Patients Only
Preparing For Your Appointment
For your convenience, we have included driving directions in the PDF link below.
Driving Directions to Connecticut Image Guided Surgery (PDF)
Please remember to bring your identification card and insurance card to your appointment. To expedite your appointment, you may complete your Patient Registration Form prior to your arrival using any of the options above. Additionally, please bring the following:
- Referral form (for HMO insurance, if required).
- List of current medications you are taking, including prescriptions, over the counter medications, and any herbs.
- Relevant information about your medical and surgical history, including any pertinent x-rays or records you may have.
- Important questions you would like to ask the doctor.