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Download Medical Imaging Forms

Film Report Request Form


FILM/REPORT REQUEST FORM
Patients, please download and fill out this form to obtain copies of your films or imaging reports. You can simply sign, scan and email your records request to imirecords@imirad.com.
If you prefer to mail or fax the form, Contact the Intermountain Medical Imaging records department at 208.954.8130.

barium-enema-small-bowel-follow-through-IVP-prep

BARIUM ENEMA ADULT PATIENT PREP
Patients, please download these preparation instructions when your physician has ordered a Barium Enema, Small Bowel Follow-Through or an IVP exam.

IVP-SBFT-prep

IVP, SMALL BOWEL FOLLOW-THROUGH PREP
Patients, please download these preparation instructions when your physician has ordered an IVP, Small Bowel Follow-Through exam.