Hill Medical
Corporation

Where to
Find us

We are proud to offer state-of-the-art diagnostic imaging services in Pasadena and Glendora, California, and surrounding counties.


Patient Forms for The Hill Medical Corporation

For Jim & Eleanor Randall Breast Center (Pasadena) ONLY

Patient Information Sheet

Thank you for choosing The Jim & Eleanor Randall Breast Center for your diagnostic procedure. Are you a new patient? Depending on your examination or procedure, you can save time by filling out the patient information sheet before your visit with us.

Download Jim & Eleanor Randall Breast Center Patient Form

Meaningful Use Questionnaire

Thank you for choosing Jim & Eleanor Randall Breast Center for your diagnostic procedure. Are you a new patient? You can save time by filling out the Meaningful Use Questionnaire form before your visit with us. If you are not a new patient, but have had medication changes, please fill out the Meaningful Use Questionnaire form before your visit with us.

Download Hill Imaging Center, Inc. Meaningful Use Form

For Huntington-Hill Imaging Center, Inc. (Pasadena) ONLY

Patient Information Sheet

Thank you for choosing Huntington-Hill Imaging Center, Inc. for your diagnostic procedure. Are you a new patient? Depending on your examination or procedure, you can save time by filling out the patient information sheet before your visit with us.

Download Huntington-Hill Imaging Center, Inc. Patient Form

Meaningful Use Questionnaire

Thank you for choosing Huntington-Hill Imaging Center, Inc. for your diagnostic procedure. Are you a new patient? You can save time by filling out the Meaningful Use Questionnaire form before your visit with us. If you are not a new patient, but have had medication changes, please fill out the Meaningful Use Questionnaire form before your visit with us.

Download Hill Imaging Center, Inc. Meaningful Use Form

For Hill Imaging Center, Inc. (Glendora) ONLY

Patient Information Sheet

Thank you for choosing The Hill Imaging Center, Inc. (Glendora) for your diagnostic procedure. Are you a new patient? Depending on your examination or procedure, you can save time by filling out the patient information sheet before your visit with us.

Download Hill Imaging Center, Inc. Patient Form

Meaningful Use Questionnaire

Thank you for choosing Hill Imaging Center, Inc. for your diagnostic procedure. Are you a new patient? You can save time by filling out the Meaningful Use Questionnaire form before your visit with us. If you are not a new patient, but have had medication changes, please fill out the Meaningful Use Questionnaire form before your visit with us.

Download Hill Imaging Center, Inc. Meaningful Use Form

For MRI patients receiving CONTRAST ONLY (Fair Oaks, Cordova and Glendora locations only)

If your doctor has referred you to our imaging center for a Magnetic Resonance Imaging (MRI) examination requiring an injection of Gadolinium‐Based MRI contrast, please take a moment to read the Consent Form and medication guides. Please bring the signed Consent Form with you on the day of your appointment. If you have additional questions regarding Gadolinium‐Based MRI contrast, please visit our Patient Education page.

A Medication Guide will be given to you on the day of your MRI with contrast exam. We encourage you to review the information in advance by using the links below. There are a number of different gadolinium-based contrast agents available, each with its own safety profile. Hill Medical has considered retention characteristics when selecting the three gadolinium-based contrast agents used at its imaging centers. Additional factors to be considered include the part of the body being imaged, your medical condition(s) and history, and prior MRI with contrast exams.

Medication Guides:
Medication Guide for Gadavist
Medication Guide for Eovist

AUTHORIZATION FOR USE OR DISCLOSURE OF PROTECTED HEALTH INFORMATION

Authorization Form

Patients, please use this form when you wish to have your protected health information released to you or another party. You may bring this form to our office or fax it to (626) 698-7187.
Download Form


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