Schedule PET Scan


To schedule a PET scan please submit the below request form. If accepted, the scan will be posted on the ALBMC PET Calendar within 24 hours. If it is not accepted, you will receive a notification via email. All requests will be processed in the order they are received. Scans will not be scheduled if required information is missing or if the study’s IRB approval has expired.  

 

PET scans may only be scheduled Monday through Friday during working hours. Please click here for radiopharmaceutical availability.

 

If you need to change or cancel your scan please contact Mary Susselman. All scans must be cancelled and/or rescheduled promptly, so the Tech can be notified of the schedule change.

  

*A radiopharmaceutical prescription is required for each PET scan

*A RDRC Verification Form is required for each RDRC PET Subject


 
Time: *
:
Duration: *

:
Scan #: *
Gender: *
Principal Investigator: *
IRB/ARC #: *
Radiopharmaceutical: *
Is this scan quantitative: *
Are there blood draws during the scan acquisition?

Please note any special instructions or comments here:
Is this an RDRC Protocol? (i.e. O15)