Locations

Sidebarmap

Choose from our several convenient locations. Find a location

Meet Our Team

Team

Get to know the more than 40 caring, experienced radiologists at EVDI See our radiologists

Home Patient Forms

Download now and save time

Here you’ll find all our downloadable forms, including registration and questionnaires. Download the items you need, fill them out at home and save time when you come to our office. Please select the category for the exam(s) you will be having and download all forms in that category. If you are having multiple exams, you only need to fill out the registration form once.

Not sure which forms you need? Please call one of our centers for assistance.

Breast Imaging - Breast MRI

Registration Form in Spanish

PDF - 108 KB
MRI Screening

PDF - 53.4 KB
MRI Breast Questionnaire

PDF - 53.2 KB
Registration Form

PDF - 89.1 KB
MRI Screening in Spanish

PDF - 48.2 KB

Breast Imaging - Breast Ultrasound

Registration Form in Spanish

PDF - 108 KB
Female Mammography & Breast Ultrasound Patient History

PDF - 51.1 KB
Male Mammography & Breast Ultrasound Patient History

PDF - 44.4 KB
Registration Form

PDF - 89.1 KB

Breast Imaging - Diagnostic Mammography

Registration Form in Spanish

PDF - 108 KB
Female Mammography & Breast Ultrasound Patient History

PDF - 51.1 KB
Male Mammography & Breast Ultrasound Patient History

PDF - 44.4 KB
Registration Form

PDF - 89.1 KB

Breast Imaging - Screening Mammography

Registration Form in Spanish

PDF - 108 KB
Female Mammography & Breast Ultrasound Patient History

PDF - 51.1 KB
Male Mammography & Breast Ultrasound Patient History

PDF - 44.4 KB
Registration Form

PDF - 89.1 KB

CT - Arthrogram

Registration Form in Spanish

PDF - 108 KB
Registration Form

PDF - 89.1 KB
Information and Consent for Joint Injection/Arthrography

PDF - 62.6 KB
CT Patient Questionnaire

PDF - 134 KB

CT - Spine

Registration Form in Spanish

PDF - 108 KB
Registration Form

PDF - 89.1 KB
Myelogram Screening Form

PDF - 40.4 KB

CT - General

Registration Form in Spanish

PDF - 108 KB
Registration Form

PDF - 89.1 KB
CT Patient Questionnaire

PDF - 134 KB

Fluoroscopy - Gastrointestinal Tract

Registration Form in Spanish

PDF - 108 KB
Registration Form

PDF - 89.1 KB
Fluoroscopy Patient History

PDF - 42.1 KB

Fluoroscopy - Kidneys & Urinary Tract

Registration Form in Spanish

PDF - 108 KB
Registration Form

PDF - 89.1 KB
Patient History - IV Contrast Exam

PDF - 42.9 KB

Fluoroscopy - Spine

Registration Form in Spanish

PDF - 108 KB
Registration Form

PDF - 89.1 KB
Myelogram Screening Form

PDF - 40.4 KB

MRI - Angiography

Registration Form in Spanish

PDF - 108 KB
MRI Screening

PDF - 53.4 KB
Registration Form

PDF - 89.1 KB
MRI Screening in Spanish

PDF - 48.2 KB

MRI - Arthrogram

Registration Form in Spanish

PDF - 108 KB
MRI Screening

PDF - 53.4 KB
Registration Form

PDF - 89.1 KB
Information and Consent for Joint Injection/Arthrography

PDF - 62.6 KB
MRI Screening in Spanish

PDF - 48.2 KB

MRI - Cerebrospinal Fluid Flow Study/Aqueductal Flow Study

Registration Form in Spanish

PDF - 108 KB
MRI Screening

PDF - 53.4 KB
Registration Form

PDF - 89.1 KB
MRI Screening in Spanish

PDF - 48.2 KB

MRI - General

Registration Form in Spanish

PDF - 108 KB
MRI Screening

PDF - 53.4 KB
Registration Form

PDF - 89.1 KB
MRI Screening in Spanish

PDF - 48.2 KB

MRI - Perfusion

Registration Form in Spanish

PDF - 108 KB
MRI Screening

PDF - 53.4 KB
Registration Form

PDF - 89.1 KB
MRI Screening in Spanish

PDF - 48.2 KB

Nuclear Medicine Scans - Abdominal Exam

Registration Form in Spanish

PDF - 108 KB
Nuclear Medicine Abdominal Exam

PDF - 52.3 KB
Registration Form

PDF - 89.1 KB

Nuclear Medicine Scans - Bone Scan

Registration Form in Spanish

PDF - 108 KB
Nuclear Medicine Bone Exam

PDF - 46.1 KB
Registration Form

PDF - 89.1 KB

Nuclear Medicine Scans - Cardiac Blood Pool (Resting Muga)

Registration Form in Spanish

PDF - 108 KB
Cardiac Blood Pool-Resting MUGA

PDF - 54.4 KB
Registration Form

PDF - 89.1 KB

Nuclear Medicine Scans - Parathyroid Exam

Registration Form in Spanish

PDF - 108 KB
Nuclear Medicine Parathyroid Exam

PDF - 45.9 KB
Registration Form

PDF - 89.1 KB

Nuclear Medicine - PET/CT Scans

Registration Form in Spanish

PDF - 108 KB
PET Patient Questionnaire

PDF - 51.1 KB
Registration Form

PDF - 89.1 KB

Nuclear Medicine Scans - Renal Exam

Registration Form in Spanish

PDF - 108 KB
Nuclear Medicine Renal Exam

PDF - 46.6 KB
Registration Form

PDF - 89.1 KB

Nuclear Medicine Scans - Thyroid Exam

Registration Form in Spanish

PDF - 108 KB
Nuclear Medicine Thyroid Exam

PDF - 49.3 KB
Registration Form

PDF - 89.1 KB

Ultrasound - General

Registration Form in Spanish

PDF - 108 KB
Registration Form

PDF - 89.1 KB

Ultrasound - Pelvic or Obstetric Exam

Registration Form in Spanish

PDF - 108 KB
Registration Form

PDF - 89.1 KB
Pelvic Ultrasound Questionnaire

PDF - 74 KB

X-ray - Arthrography

Registration Form in Spanish

PDF - 108 KB
Registration Form

PDF - 89.1 KB
Information and Consent for Joint Injection/Arthrography

PDF - 62.6 KB

X-ray - DXA Bone Densitometry

DXA Patient History

PDF - 55.4 KB
Registration Form in Spanish

PDF - 108 KB
Registration Form

PDF - 89.1 KB

X-ray - General

Registration Form in Spanish

PDF - 108 KB
Registration Form

PDF - 89.1 KB

Business Office

1125 E. Southern Ave.
Suite 300
Mesa, AZ 85204
480-545-9779 (phone)
480-545-0102 (fax)

Medical Records

1156 W. Southern Ave.
Suite 106
Tempe, AZ 85282
480-366-4300 (phone)
480-366-4390 (fax)