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Mobile Imaging Request Form 
CIS offers mobile CT and MRI rentals for both long term and interim use.  Please call us or fill out the request form with your specific needs for a quotation.

Facility Name:
 *
First Name:
 *
Last Name:
 *
Phone
 *
Email Address:
 *
Address:
 *
City:
 *
State:
 *
Zip Code:
 *
System Needed:
Start Date:
End Date:
Describe Your Needs:
Do not enter anything in this field:
* indicates a required field

Currently Looking to Purchase:
  • GE CT Scanners
  • Multi-Slice CT
  • CR Units
  • Open MRIs
  • HF Rad Rooms

 

    Now Available:
    • GE Light Speed 16
    • GE QX/i 4
    • GE NX/i Dual
    • Philips Brilliance 64
    • GE 1.5 Shortbore Mobile
    • Siemens Symphony

     


      Clinical Imaging Systems, Inc.
      522 Highway 9 North Suite 321
      Manalapan, NJ 07726  
      Toll Free: 1-866-585-7164
      Phone: 1-732-591-9510  
      Fax: 1-732-226-3168
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