Patient Forms

AAA Screen US Patient Form

Authorization to Receive Protected Health Information

Authorization to Send or Disclose Protected Health Information

Authorization to Use or Disclose Protected Health Information

Billing Information of Auto Accident Claim Filing

Body Imaging Patient Form

Brain Imaging Patient Form

Breast Imaging Patient Form

Carotid Ultrasound Patient Form

CT Chest Screening Patient Form

CT or US Chest Abdomen Pelvis Patient Form

DEXA Imaging Patient Form

Kinship Caregivers Informed Consent Declaration for Minors

MRI Screening Questionnaire

Notice of Privacy Practices

Orthopedic Imaging Patient Form

Parental Consent- Advance Consent to Treat Minors

To Parents and Guardians of Minor Children

Patient Intake Form

Respiratory (Chest or Lung)

Sinus Imaging Patient Form

Spanish MRI Screening Questionnaire

Spanish Mammography Patient Form

Spanish MRI Brain Patient Form

Spanish Orthopedic Patient Form

Spanish Patient Intake Form

Spine Imaging Patient Form


Tri-City Radiology
7221 W. Deschutes Ave., Ste. A Kennewick, WA 99336
Ph: (509) 374-4030
Fx: (509) 374-8690

Se habla EspaƱol.

Office Hours:

About Tri-City Radiology

Leaders in radiology in southeastern Washington,
Tri-City Radiology was established in 1952 and has remained on the cutting edge of technology in the imaging arena. TCR holds the areas only ACR accredited CT and MRI programs.

Tri-City Radiology Services

Our top priority is to provide radiology services with the highest quality equipment and technologists in a comfortable atmosphere. All of our technologists are certified in their area of expertise. Our physicians have over 100 years combined medical experience and are certified by the American Board of Radiology.

Tri-City Radiology Pricing

If you are looking for radiology services and have a high deductible or no insurance,
Tri-City Radiology is your most affordable choice for advanced medical imaging. We encourage our patients to do their own cost comparison. We have flexible payment options and your statement includes all your imaging, supplies and reading fees.

Schedule a Tri-City Radiology Exam

Contact us today at
(509) 374-4030 to schedule your appointment. Same day services are available and our radiologists will have the results to your physician within 24 hours. We pride ourselves in on-time, same- and next-day appointments along with convenient easy access parking.