9844 S. 1300 E. #175 - Sandy, UT 84094   ~  Phone (801) 576-1290 Fax (801) 572-7629
 
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Printable Documents

Please print off any forms you may need prior to coming, to lower your waiting time.

Required Forms

1. Patient Information
2. Questionnaire
3. HIPAA
4. Financial Agreement

Specific Scan Forms (Choose which form based on what you are scanning)

 1. Brain
2. Back
3. Shoulder
4. Elbow
5. Upper Extremity
6. Pelvis
7. Thigh
8. Knee
9. Lower Extremity

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Wasatch Imaging Center, LLC 2004 - All rights reserved               Email: WasatchMRI@msn.com