Cooperative Magnetic Imaging Safety Screening Questionnaire

Dear Patient,

Please print this form, complete and bring with you to your MRI appointment. This is an important form which needs to be completed before you have your MRI. If you have any questions about this form, please contact us at our Main Office at 315-792-4666. Thank you.

Safety Questionaire

Billing Form

Consent for Contrast

HEALTHeCONNECTIONS Consent