Below are the necessary patient forms that you will need for your visit to Med 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 Med Tech Imaging Center at (334)-358-1666.
Authorization For Use and Disclosure of Protected Health Information
Consent For Intravenous MRI Injection
CT Questionaire-Consent For Intravenous Injection
MRI Patient History-Safety Screening
Notice of Privacy Practice Acceptance
Patient Statement of Pregnancy-Nursing Condition
Where Patient ComeFirst