A tradition of Excellence in Patient Care

 

Patient Forms.

The links below comprise a set of all forms (Adobe PDF format) you will be required to fill out prior to your exam. It is recommended that you fill out basic demographics prior to printing; as basic data will automatically populate all forms. Once completed, please print out these forms and bring them with you on your appointment date. You will also need to bring your insurance card and an official photo identification (for example, Texas Driver’s license). For your convenience a map is provided on the last page.

Forms

Save the forms in your desktop then you can email at it@hmixray.net

CT SCAN

Download PDF

DIGITAL X-RAY

Download PDF

FILM RELASE FORM

Download PDF

FLUOROSCOPY

Download PDF

GENERAL PACKAGE

Download PDF

MAGNETIC RESONANCE MRI

Download PDF

MAMMOGRAPHY

Download PDF

NUCLEAR MEDICINE

Download PDF

MAMMOGRAPHY RELEASE FORM

Download PDF

PET SCAN

Download PDF

PREGNANCY RELEASE FORM

<Download PDF

ULTRASOUNDAND ECHOCARDIOGRAM

Download PDF