Download now and save time

Now you can download the items you need, fill them out at home and save time when you bring them to your appointment.

All Patients: Please print and complete all forms found in the All Patients area.

Specialized Forms: Select from any other section that also applies to you.

Please remember to bring your insurance card and your order form if it was provided by your doctor. Thank you for choosing SMIL.

All Patients:

Financial Policy Form - 210KB

Financial Policy Form (Spanish)- 223KB

Registration Form - 221KB

Registration Form (Spanish) - 248KB

Request for Release of Images and Reports - 670KB

Mammograms:

Mammogram Waiver - 210KB

Mammogram Waiver (Spanish) - 176KB

MRI:

MRI Screening Questions - 279KB

MRI Screening Questions (Spanish) - 295KB

DEXA:

DEXA Bone Density History Form - 402KB

MINORS:

Minor Consent Form - 134KB