Pre-Visit Forms

Below are the necessary patient forms that you will need for your visit to High Tech Imaging Center.

If you are scheduled to have a procedure performed or you have been asked to complete one of these forms by a member of our staff, please download and print the document below. Complete the form by hand and bring it with you to your appointment.

If you have any questions, please contact High Tech Imaging Center at (334) 265-7213.

All Forms

Referal Form

Authorization For Use and Disclosure of Protected Health Information

Consent For Intravenous MRI Injection

CT Questionaire-Consent For Intravenous Injection

MRI Patient History-Safety Screening

Notice of Privacy Practice Acceptance

Patient Information

Patient Statement of Pregnancy-Nursing Condition

Privacy Policy HIPPA Disclaimer