Fill out form or call 1-480-767-3227

Appointments are scheduled as:
Office Visits, Home Visits,
Corporate Office Visits,
or Public Screening Events

For a list of our public screening events, please click: Public Screening Events

First Name *

Last Name *

Street Address

City

State (currently in AZ only)

Zip Code

Phone Number *

Email Address *

Please pick the type of event you would like to schedule. *

Tell us about the attendees.

Who referred you to us? If no one, simply type "self".

Note: Discounts apply for larger groups.

Have you, or your company been screened by Cardio Centrix before? *

Choose A Date

Note: A Representative will contact you within 24 hours,
during regular work hours, to schedule your test. Regular
work hours are M-F from 8:00a.m. - 5:00p.m.

Date Requested * +

Preferred Time *

Second Choice * +

Preferred Time *

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