To make your visit to Pleasanton Diagnostic Imaging as easy as possible, download and fill out these forms before you arrive.
Every patient should fill out these forms.
- Authorization for Release of Information (PDF)
- Patient Consents to Procedures / Responsibility – English (PDF)
- Patient Consents to Procedures / Responsibility – Spanish (PDF)
Find the service you are visiting us for and download the appropriate form.
|Bone densitometry (DEXA)||Osteoporosis Risk Questionnaire|
|Magnetic resonance imaging (MRI)||
MRI Screening Questionnaire
Intravenous Contrast – Consent Form (for MRIs done with or without contrast)
|Computed tomography (CT)||
CT Medical History and Contrast Questionnaire
Consent for Contrast Injection (for CTs done with contrast)