Call Today (518) 785-7373
Services
Services
3T MRI
Open MRI
CT
3D Mammography
Second Read AI
Bone Densitometry (DXA)
Ultrasound
X-Ray
LDCT
Patients
Patient Portal
Patient Forms
Payment Portal
Insurance
Physicians
Physician Portal
Referral Forms
Your Health
About Us
Contact
Leave A Review!
Request an Appointment

Capital Imaging Associates

Call Today (518) 785-7373
Services
Services
3T MRI
Open MRI
CT
3D Mammography
Second Read AI
Bone Densitometry (DXA)
Ultrasound
X-Ray
LDCT
Patients
Patient Portal
Patient Forms
Payment Portal
Insurance
Physicians
Physician Portal
Referral Forms
Your Health
About Us
Contact
Leave A Review!
Request an Appointment
  • Patients
  • Patient Portal
  • Patient Forms
  • Payment Portal
  • Insurance

Patient Forms

Click on the appropriate forms to download. Please print the form, fill it out, and bring it with you to your appointment. Thank you!


Abdomen/Pelvis Evaluation Questionnaire

Breast Imaging Questionnaire

Chest Evaluation Questionnaire

Consent for Contrast Administration

Consent for Diagnostic Procedure

DXA Scan Questionnaire

Esophagram, Upper GI, Small Bowl Series

Head/Neck/Spine Questionnaire

Lower Extremity Questionnaire

MRI Contraindications

Pelvic Ultrasound Questionnaire

Upper Extremity Questionnaire


Request An Appointment

locations

Capital Imaging Associates is conveniently located in Latham and Clifton Park, NY.

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Capital Imaging Associates

 

Clifton Park

3 Emma Ln.
Clifton Park, NY 12065

Latham

1001 Loudon Road,
Latham, NY 12110

For GPS use 12047 zip code

 

Phone: (518) 785-7373 | Fax: (518) 786-8271 | Email: info@capimaging.com

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