Fair Lawn Diagnostic Imaging Center

Diagnostic Imaging

Fair Lawn, NJ

(201) 794-3132

Patient Registration

To better convenience you, we have allowed patients to download(.pdf) and print the procedural forms below to shorten the time spent in the waiting room.

Click the download link to view the form or Right Click your mouse on the link then select "Save Target As" from the menu to save it to your computer.

Forms

Patient Registration Form - Download

Patient Authorization Responsibility Form - Download

 

Questionnaires

CT Patient History Questionnaire - Download

MRI Patient History Questionnaire - Download