Share Your Story

• Tell us how the DRA imaging cuts are affecting you!
• Tell Us Why Imaging Matters to You

Tell Us Why Imaging Matters to You

Has medical imaging technology had a profound impact on your life, that of a family member or someone for whom you have helped provide care?  Did medical imaging provide an earlier or more accurate diagnosis?  Did it prevent an unnecessary surgery?  Did it provide for more accurate and effective treatment of a life-threatening disease?  If so, we hope you will share your experience with Imaging Access and allow us to piece together a picture of the many "real life" reasons why Congress must preserve access to this truly amazing and life-altering technology. 

1.  Please tell us your story, and note the medical imaging modality(s), such as MRI, ultrasound, CT, X-Ray, PET, nuclear cardiology, that were employed.

Are you willing to speak with the media or Congressional staff members about your experiences?
	Yes No
We intend to use the information you provide with the news media and in our advocacy efforts in Congress. Are you willing to let us use your name in those efforts?
	Yes No
Please provide contact information
Your Name:
Your E-mail:
Job Title:
Address:
City:
State:
Zip:
Phone:

Tell us how the DRA imaging cuts are affecting you!

AMIC is collecting information about how the imaging payment reductions under the DRA-'05 are affecting providers and patients. These "real-world" experiences are important in helping us explain the impact of the DRA to Members of Congress and the news media.

If you would like to share your experiences, please answer the following questions. We will use this information to support our efforts to delay further implementation of the payment cuts. If you are willing to let us use your name, please indicate in the appropriate box below.

PHYSICIANS, IMAGING SERVICES PROVIDERS
Are you reducing imaging services in any way as a result of the DRA imaging reductions? If so, how?
	Yes No
Comments
What other changes are you making, or have you already made, as a result of the imaging payment reductions, e.g. limiting or curtailing new Medicare patients, canceling contracts to purchase advanced imaging equipment, reducing the number of employees, etc?
	Yes No
Comments
What do you think will be the likely long-term effect of these changes on the availability of imaging services for patients in your area? For your ability to provide these services to Medicare patients? For your ability to provide imaging services to all patients?
	Yes No
Comments
PATIENTS/PATIENT ADVOCATES (i.e., family members)
If you are a patient, have you had difficulty getting imaging services since the passage of the DRA cuts? (This might include having to drive further for services, physician practices that have discontinued certain imaging services, etc.) Please explain.
	Yes No
Comments
Have you had to wait longer than usual for Medicare imaging services?
	Yes No
PROVIDERS AND PATIENTS
Are you willing to speak with the media or Congressional staff members about your experiences?
	Yes No
We intend to use the information you provide with the news media and in our advocacy efforts in Congress. Are you willing to let us use your name in those efforts?
	Yes No
Please provide contact information
Your Name:
Your E-mail:
Job Title:
Address:
City:
State:
Zip:
Phone: