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St. Charles Imaging Center 558 St. Charles Dr. Suite 111 Thousand Oaks, Ca. 91360 (805) 2302700 Fax (805) 2302750 www.stcharlesimaging.comMRI SCREENING INFORMATION FOR PATIENTSPatient Name Date Nastiest
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Charles Imaging Center is a medical facility that provides imaging services such as X-rays, MRIs, CT scans, and ultrasounds.
Healthcare providers who operate imaging centers or facilities are required to file Charles Imaging Center forms.
Charles Imaging Center forms can be filled out electronically or by hand, providing information such as patient details, procedures performed, and billing codes.
The purpose of Charles Imaging Center is to accurately report imaging services provided to patients for billing and insurance purposes.
Information such as patient demographics, referring physician, type of imaging procedure, dates performed, and billing codes must be reported on Charles Imaging Center forms.
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