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All Patients

Patient Information

Patient History

HIPAA Privacy Notice

Medical Insurance Liability

Requisition Form

MRI Scans Only

MRI Safety Questionnaire

Pregnancy--MRI Consent (if you are pregnant)

Special Radiology Procedure Only

If you are also having a radiology procedure involving needle insertion (such as a biopsy), please complete the following: 

Radiology Procedure Consent

copyright © 2004 ray h. hashemi, m.d., ph.d.