Forms:

Listed here are some of the forms you may need to fill out for your visit.  Not all patients are required to complete all forms.  Choose the forms based on the procedure you are scheduled for.  Please print the applicable forms and bring them with you to your appointment.

All patients will be required to complete the first three pages of this package.  The forms include a demographic page, HIPAA and financial agreement document and a patient history form.

If you are scheduled for an MRI, you will be required to complete this screening form to assist our technologists in ensuring a safe, effective MRI procedure.

IV Contrast is sometimes given to CT or MRI patients.  If your physician has ordered an examination WITH CONTRAST, you will be required to complete this form.

If you are scheduled for a DEXA scan, also known as a bone density scan or osteoporosis screening, you will be required to complete this information.

This form must be completed if the procedure is to be perfomed on a minor under the age of 18.  A parent or guardian must be the one to complete this infomation.

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