Patient resources
Documents for your visit
Download and complete the documents relevant to your examination before arriving at the practice. Each link opens the latest PDF currently provided by ImagePro Radiology.
Patient Information Form
Provide your personal, clinical, medical-aid and account information, together with the required declaration and consent.
View or download PDFMRI, CT & IVP Questionnaire
Complete the safety questionnaire covering relevant medical conditions, medication, allergies, implanted devices and pregnancy.
View or download PDFPatient Responsibility Form
Record your decision regarding payment responsibility, medical-aid authorisation or proceeding with the requested examination.
View or download PDFCardiac Device or Valve
For MRI patients with an MRI-safe or conditional cardiac pacemaker, implant or valve. Includes doctor and device details.
View or download PDFPregnant Patients
For pregnant patients proceeding with an MRI after clinical discussion. Records the examination, pregnancy stage and consent.
View or download PDF