Tower Radiology Centers script 2026

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  1. Click ‘Get Form’ to open the Tower Radiology Centers script in the editor.
  2. Begin by entering the patient’s name in the designated fields for First, Middle Initial, and Last name.
  3. Fill in the Date of Birth (DOB), Appointment Date, and Time in their respective fields to ensure accurate scheduling.
  4. Indicate any allergies by checking 'NKA' if there are none or listing specific allergies as needed.
  5. Complete the Diagnosis or Signs/Symptoms section by listing up to three relevant conditions or symptoms.
  6. The Ordering Physician section requires you to print the physician's name, signature, and date to validate the request.
  7. Select the appropriate MRI type and any additional exams required by checking the corresponding boxes.

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2019 4.6 Satisfied (28 Votes)
2012 4 Satisfied (50 Votes)
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