Patient Forms

In order to streamline the registration process and reduce the wait time of your visit, please download, print, and complete the forms below. In order to help protect our patients’ identities, effective May 1, 2009, all Valley MRI & Radiology patients will be asked to show a valid proof of ID, such as a Federal or State issued drivers license, military or government ID card or passport.

All files are saved in Adobe pdf format and require Adobe Acrobat Reader to view. Click here to download a free copy of the viewer.

Downloadable Forms*

*Please advise: These forms are not submitted electronically. You will need to please print, fill them out completely and bring them with you to your appointment.

Authorization for Release of Health Information

Financial Policy

Intake Form

Medical Records Policy

Patient Registration Form

Privacy Policy