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Patient
Appointment
Forms

Filling out forms before you get to your appointment can save time. The forms below are fillable and you will need to print them in order to submit them at your appointment. For your convenience, our most commonly used forms are directly below, and forms for our most frequently done exams are grouped by exam after that.

General Forms 

Mammography

Bone Densitometry Adult

Bone Densitometry Pediatric

X-ray

Intravenous Pyelogram – IVP

Ultrasound

MRI

CT – PET Scans – Myelograms

Fluoroscopy

Hysterosalpingogram (HSG)

Nuclear Medicine

Pediatric Sedations

(In addition to exam forms listed above)

  • Pediatric Sedation Form (English | Spanish)
  • Pregnancy Release Form for Visitor (For any female visitor ages 10 to 55 going in the exam room) (English | Spanish)
  • Metal Screening Form for Visitor (If a patient is having an MRI and a family member would like to go in the exam room) (English | Spanish)

Interventional EVLT Consults

Interventional Consults

Interventional Procedures

 

See information on sedation and pain management if needed for a procedure.

Scheduling Notice

ARA is experiencing record call volumes. We are aggressively working to remedy this situation. PLEASE NOTE THAT SCREENING MAMMOGRAMS AND ULTRASOUNDS CAN BE SCHEDULED ONLINE. If you schedule a callback and your call is not received during the predicted time frame, please note you are still in the queue and we will call you back as soon as an agent is assigned to your call. We apologize for the extra wait time you may experience and appreciate your patience. For routine X-ray, scheduling is not required--you can walk into any ARA location that does X-ray.

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