Forms

Bone Densitometry Questionnaire

CT Contrast Consent

CT Contrast Consent

(Spanish)

Health History

Industrial Accident Form

Language Assistance Notice

MRI Patient ScreeningForm

MRI Patient Screening Form

(Spanish)

MRI Contrast Consent

Medical Records Release Form

Medicare Authorization Form

Motor Vehicle Accident Form

Notice of Non-Discrimination

Notice of Privacy Practices

Notice os Privacy Practices

(Spanish)

Notice of Privacy practices Receipt

Notice of Privacy Practices Receipt

(Spanish)

Patient Registration Form

Pregnancy Questionnaire

Pregnancy Questionnaire

(Spanish)

Request to Access PHI

Quality is our image.

Located in both Idaho Falls and Rexburg!

Teton Radiology

2001 S. Woodruff Suite 17 Idaho Falls, ID

(208) 524-7237

support@tetonradiology.com

Teton Radiology Madison

425 E. 4th N. Rexburg, ID

(208) 356-4888

support@tetonradiology.com

Opening Hours

Monday:     8:00am - 5:00pm

Tuesday:     8:00am - 5:00pm

Wednesday:     8:00am - 5:00pm

Thursday:     8:00am - 5:00pm

Friday:     8:00am - 5:00pm