All patients must complete pre-visit forms.
There are three options to complete these forms.
- You can either complete them online by clicking on the yellow box below (recommended). Only complete once you have a scan time scheduled. Please arrive 15 mins before your scan.
- You can download them from the links on this page, print them out, complete, and then present them to our receptionist on arrival. Please arrive 15 mins before your scan.
- You can complete them when you arrive at our center. For existing patients, please arrive 15 mins prior to your scan. For new patients, allow 30 mins.
If you wish to download the pre-visit forms to your PC or Mac and print them out, please see the links below.
Please click here to download the registration form and here to download the assignment of benefits/release of information form.
Note – for the assignment of benefits/release of information form, please enter the date of your scan (date of service) when signing this form.
If you are having an MRI and/or an MRI of the prostate, a CT or PET/CT or Nuclear scan, please complete the forms below as well.
For patients having an MRI, please download the following screening form here to download.
For patients having a Prostate MRI, please download the following form here to download.
For patients having a CT or a PET/CT or a Nuclear scan, please click here to download.
If you are having contrast with your CT, PET/CT or Nuclear scan, please click here for the contrast form to download.
If you are a first time patient for Breast Imaging, please click here for the breast history form.
If you are a first time patient for DEXA imaging (Bone Density), please here for the Dexa questionnaire form.
Scan Information:
MRI and MRA
Because of the strong magnetic field used in MRI, certain metallic devices may prevent us from performing an MRI. At the time of scheduling we will ask whether you have any of the following; aneurysm clips, cardiac pacemaker/defibrillator, neurostimulator, hearing aid, internal or external metallic objects, or any other implant or prosthesis. During the exam you will hear loud repeating knocking. Headphones and listening to music are available. If you wish, you may bring your own music selection. If conscious sedation is ordered by your physician, please call us for special instructions. Depending on the type of exam ordered, it usually takes from 20 to 45 minutes. Our technologist will monitor and support you throughout the exam. An intercom system will enable our technologist to communicate with you.
PET / CT
Other than water, please do not eat or drink 6 hours before your scheduled appointment. It is important to drink plenty of water to be well hydrated for your scan. If you are diabetic, we recommend fasting for 4 hours(water is still okay) because we want the blood glucose levels to be about 100mg/dl. We cannot do the PET/CT scan if the blood glucose is above 200mg/dl. Because of the need to keep blood glucose levels low, it is important that in the evening before the scan, you eat a low carb/low sugar diet for dinner including any snacks. Please also have a low carb breakfast on the day of the scan, if you have an afternoon appointment. You may take any medications that do not need to be taken with food. Any medications that are required to be taken with food should wait until after your scan.
About one hour prior to the scan, we will obtain a blood sugar level from you and inject a small amount of a radio-pharmaceutical into a vein in your arm or hand. Unfortunately, we do not have the ability to access ports. You will then be asked to relax in a private room until you are ready for the scan. The scan usually takes anywhere from 20 to 30 minutes, but plan on being at our center for a total of 2 to 3 hours.
PET/CT scans are safe. The radio-pharmaceutical that is injected is a small dose and is rapidly eliminated from the body. Once your scan is completed, please drink plenty of fluid, empty your bladder often and wait several hours before getting close to infants and women who are pregnant.
CT & CTA
Patients who require intravenous (IV) injection of contrast material as part of their CT exam and are diabetic, have renal disease, or are severely debilitated will need to have a serum creatinine level drawn within 30 days of the exam. Do not eat or drink 4 hours prior to exams with IV contrast. Most CT scans of the abdomen and pelvis also require drinking of an oral contrast drink that we supply through your ordering physician or can be obtained at our center prior to your appointment. The exam usually takes from 10 to 30 minutes to complete.
Ultrasound
For an abdominal or gallbladder ultrasound, please eat a low fat dinner the evening before and do not eat or drink at least 6 to 8 hours prior to your scheduled appointment. For pelvic or first trimester obstetrical ultrasounds, drink 32 ounces of water 1-2 hours prior to your appointment. Do not empty your bladder prior to the exam. All other ultrasound exams do not require preparation. The exam usually takes from 10 to 30 minutes to complete
X-Ray
You will be asked to remove jewelry or metal objects that might interfere with the x-ray images. Otherwise, no preparation is required. Most exams are completed in less than 20 minutes.