Below are the necessary patient forms that you will need for your visit to High Tech Imaging Center.
If you are scheduled to have a procedure performed or you have been asked to complete one of these forms by a member of our staff, please download and print the document below. Complete the form by hand and bring it with you to your appointment.
If you have any questions, please contact High Tech Imaging Center at (334) 265-7213.
|Authorization For Use and Disclosure of Protected Health Information||Download|
|Consent For Intravenous MRI Injection||Download|
|CT Questionaire-Consent For Intravenous Injection||Download|
|MRI Patient History-Safety Screening||Download|
|Notice of Privacy Practice Acceptance||Download|
|Patient Statement of Pregnancy-Nursing Condition||Download|