WK Advanced Cardiac Imaging - Willis Knighton North

Required Patient Forms

New patients should arrive 30 minutes prior to the appointment time so that we can process the information, create the medical file and place the chart in line for the designated appointment time. Bring all medications in their original bottles (not a pill box) to your appointment. Be sure to include any over-the-counter medications you current take.

• New Patient Information Record (Can be completed online)
• Patient Identification Data (Can be completed online)
• Authorization to Disclose Protected Health Information (Can be completed online if needed)
• Notice of Privacy Practices