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Patient Forms & Resources

Click on the links below to download printable forms that you can bring to your next doctor's visit.

Common Forms
  • Healthcare Proxy
Consent Forms
  • Telemedicine Consent (English)
  • Telemedicine Consent (Spanish) - Authorizacion Consulta de Telemedicina
Patient Information and Resources
  • Colonoscopy Preparation
  • Child Advocacy Resoures
  • How to Complete the MSPQ - A Guide for Patients
Patient Imaging Forms
  • Computed Tomography (CT/CAT) Scan
  • Gastrointestinal (GI) Procedure
  • Interventional Radiology (IR)
  • Magnetic Resonance (MRI /MRA) Imaging
  • Nuclear Medicine
  • PET/MRI
  • PET/CT
  • ULTRASOUND (US)

Site Links

  • Home
  • Sign Up (I Have An Activation Code)
  • Sign Up (I Don't Have A Code)
  • Access For My Kids/Family/Friends
  • Patient Forms
  • Help & Support

Additional Resources

  • UR Medicine Labs Locations
  • UR Medicine Imaging Locations
  • MedlinePlus® Health Information Resource
  • Cost Estimates
  • Ask A Medical Librarian

Contact Information

Phone Number

» 1-888-661-6162, Opt. 1

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Help & Support

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