Imaging and Urgent Care | Baptist health South Florida http://bapth.lt/1S8Zf3s
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Forms for Imaging & Urgent Care Centers

Forms You Can Complete Before Your Visit

As an added convenience and because we value your time, you now have the choice to complete some of the forms related to your visit prior to your arrival to our imaging or urgent care centers.

Please select, print and complete the appropriate forms for a faster registration process.

Please be sure to bring your physician prescription to your Imaging appointment.

For your Urgent Care visit, please note that completing the electronic forms prior to your arrival is not required for any of our Urgent Care Services, nor is a physician's prescription. 

Thank you for visiting a Baptist Health Center!

Please be sure to bring your physician’s prescription.


 

Urgent Care

Form Urgent Care 
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MRI (without contrast)

Form MRI without contrast 
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MRI (with contrast)

Form MRI without contrast 
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CT (without contrast)

Form CT without contrast 
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CT (with contrast)

Form CT with contrast 
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Mammography
(Screening or Diagnostic)

Form Mammography screening or dignostic 
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Breast Ultrasound

Form Breast ultrasound 
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