By agreeing to the terms of our secure forms, you will enter a secure area of our site. Fairfax Radiology will not be held responsible in the event your electronic message is not transmitted due to technical problems related to this site or to the hosting server. All personal identifying information is encrypted and your message will not be internally or externally forwarded to other third parties. The information will solely be used by Fairfax Radiology.

Your request will be processed during normal business hours, Monday - Friday, 8:00 am - 5:00 pm, excluding holidays.

If you do not accept the terms of this disclaimer, we will not be able to process your online request.

Agree

Should you have a problem accessing our online forms, you can call one of the numbers below.