NWDC Diagnostic Imaging

Pre-Register

In order to speed your arrival and registration at our center, we would like to encourage our patients to pre-register and complete the necessary forms ahead of time. You may click on the forms below to download them (requires Adobe Acrobat).

For all patients:

Patient registration form - if you have never been seen at our imaging center

Health questionnaire - for all patients to complete prior to each visit (except DEXA and XRay)

Pregnancy release and consent - required for all pre-menopausal women

Prep Instructions and Informed Consents:

CT	Patient registration form Health questionnaire Pregnancy release and consent CT Prep - routine CT Prep - Virtual colonoscopy Informed Consent for Iodine Contrast
MRI	Patient registration form Health questionnaire Pregnancy release and consent MRI Prep MRI Screening and Informed Consent
Nuclear Medicine	Patient registration form Health questionnaire Pregnancy release and consent Nuclear Medicine Prep Stress test information/instruction sheet (nuclear or non-nuclear testing) Consent for Exercise Stress Testing (nuclear or non-nuclear testing)
Ultrasound	Patient registration form Health questionnaire Ultrasound Prep
DEXA	Patient registration form Pregnancy release and consent
XRay	Patient registration form Pregnancy release and consent