Information for Patients

Please print, fill out, and fax your completed forms to us at (281) 487-1766. You can also scan/email, postal mail, or hand deliver the forms if you would like. Feel free to contact us with any questions you may have regarding the forms.

MRI Questionnaire Sedation Consent
Ultrasound Questionnaire Contrast Consent
CT Questionnaire Patient Registration

 

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For Patients:

Contact Information

Fairmont Diagnostic Center
3692 East Sam Houston Parkway
Pasadena, TX, 77505-3102

(phone) 281.487.6736
(fax) 281.487.1766