Request a Service Appointment

Tell us what equipment needs attention and your preferred date. CGM Imaging Services will confirm the final service time.

Service Request

Send the equipment details

The more detail you provide, the easier it is to prepare for the service call.

For equipment-down or urgent issues, call CGM Imaging Services directly after submitting your request.

Facility Name *

Contact Name *

Phone *

Email *

City / State

Equipment Type

Manufacturer / Model

Urgency

Preferred Service Day (subject to availability)

Preferred Time (subject to availability)

Scheduling: Requested day and time are preferred only and may not be available. CGM Imaging Services will confirm the final appointment time with the facility.

Issue Description

I acknowledge CGM Imaging Services’ Billing & Payment Terms, including that parts and equipment may require payment before an order is placed.

Privacy notice: Do not submit patient names, medical record numbers, dates of birth, patient images, or other protected health information (PHI) through this form. Use equipment and business contact information only. See our Privacy Policy.

No appointment is final until confirmed by CGM Imaging Services.