Forms

For your convenience, we have provided these forms for you. Filling out the proper forms will expedite your visit. Please read all 3 steps before filling out your forms.

Our forms are in a PDF format and can be opened with Adobe Reader. You can download Adobe Reader free at Adobe

Step 1.

Fill out the form for the procedure you are having done.

MRI Procedures	CT Procedures
MRI - Breast
MRI - Chest, Abdomen or Pelvis	CT - Chest, Abdomen or Pelvis
MRI - Head or Spine	CT - Head or Spine
MRI - Joints	CT - Joints

Step 2.

Print out the forms on your home or office printer.

Step 3.

Bring the forms with you to Tallahassee Diagnostic Imaging.

Note: If you are unable to keep your scheduled appointment, please call (850) 656-2261 by 6:00pm the day before your appointment to avoid a twenty-five dollar ($25) missed appointment fee.

Forms

Step 1.

Step 2.

Step 3.

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