Forms
Before your radiology study, we recommend you fill out the following documents which apply to you and bring them in with you. This ensures that we have all the information we need before starting the exam, reduces your wait time, and eliminates delayed exams. If you do not have a printer, or wish to fill these out in person, please show up for your exam at least 20 minutes early.
New Patient Forms
New address form - For returning patients with changes to their insurance or address.
MRI Appointments
Consent for MRI Contrast Administration
Consent for MRI & Contrast Administration during pregnancy
Arthrograms
Consent for Invasive Procedure
Work-related Injury
Workman's Compensation - If this exam is because of an work related injury.
Female Patients of Child-bearing Age
Documentation of Pregnancy - Women of child bearing age.
Request your image CD or reports
Your study images and report(s) may be sent to the facility of your choice or you may pick them up and bring them with you to your appointment.
Your medical record is maintained in a strict, confidential manner as required by state and federal laws. We will not release information contained in your medical record without your written authorization or as permitted by law.
Authorization to release records