Thank you for choosing Independent Imaging. Once you have made your initial appointment, you may pre-register by downloading, printing, and completing the forms below. Please be sure to bring them with you to your visit, along with any previous diagnostic images and/or pathology reports. Completing the forms prior to your visit will help speed up the new patient registration process.
- Patient Information Sheet
- Mammo Records Request Form
- Notice of Privacy Practices
- Notice of Privacy Practices 2
- Patient Acknowledgement Receipt of Privacy Practices
Please note: It may take a few minutes to load the forms if you are using a slow internet connection. If you are unable to view the forms, you may need to download Adobe Acrobat for free by clicking on the icon below.