1. Purpose of the Funding of Medical Imaging Services Section

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* 1. Facility Name:

In the following pages, we ask several questions regarding your facility's current ability and methods of financing medical imaging. We recognize the sensitive nature of this information and only seek it to assist you in developing a financially sustainable radiology practice. All information collected in this section will be kept strictly confidential unless you provide us with permission to do otherwise.

Our shared goal is to provide the highest quality sustainable care to your patients.

The data gathered in this section will be used to:

1. Create a sustainability plan for your institution's radiology practice

2. Help you develop an effective approach to applying for loans and other forms of capital financing to fund the purchase, operation, and maintenance of radiology equipment

3. Identify the most useful borrowing options for you as your facility grows

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