Women's Imaging Specialists Patient Forms

To expedite the check in process on the day of your appointment, please fill out the paperwork that corresponds to the exams you will be having. If you need to save your progress, click “Save” at the bottom and return within 7 days using the link that is emailed to you.

If your appointment is for a Diagnostic Mammogram and/or Breast Ultrasound and your most recent mammogram was performed at another hospital or facility, those films will be needed during your appointment for comparison purposes. Please make arrangements to have a CD of your prior images sent to our office ahead of time, or you may bring them with you to your appointment.

New Patients (GA)

Georgia-specific new patient forms

New Patients (AL)

Alabama-specific new patient forms

Returning Patients

WIS Returning patient paperwork

DEXA Packet

DEXA/Bone Density Patient Packet

Medical Release

Authorization to Obtain/Disclose PHI

General Ultrasound

General Ultrasound Patient Paperwork

GA Mammo Release

Georgia-specific Mammogram Release

AL Mammo Release

Alabama-specific Mammogram Release


Paperwork Packet for X-ray Patients