There are 3 forms you will have to fill out before we perform your imaging procedure.

You can click on each form to download and print a PDF version. By filling these out before you arrive, you can minimize the amount of time you'll spend in our waiting room. Spanish versions of our forms are available as well.

English Forms:

*Please note that ALL THREE forms must be completed before your procedure. You may submit the Patient Information form online by filling it out below, but you will still need to print and complete the Patient Screening Form and the Treatment Authorization & Release of Information Form prior to your procedure. 


To help save some trees and make things just a little easier for our patients, you can now fill out the Patient Information Form online prior to your appointment. 

*Please note that this is only one of the three forms that must be completed before your procedure. Please print and complete the Patient Screening Form and the Treatment Authorization & Release of Information Form.

Name *
Name
Telephone Numbers
Personal Information
Sex *
Marital Status *
Emergency Contact Information