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Patient Forms

Click the icon to download the required form.

New Patient Registration Form - English

New Patient Registration Form - English

New Patient Registration Form - Spanish

New Patient Registration Form - Spanish

Designation of Personal Representation

Designation of Personal Representation


About Us

When you need medical imaging, you deserve the best and we provide it! From CTs and MRIs, to mammograms and more, we’re centered on you.

Policies & Notices

Notice of Non-Discrimination
Notice of Privacy Practices
Privacy Policy

Directions

Fountain Point Imaging Center is located at
3901 W Norfolk Ave Suite R, Norfolk, NE 68701

© 2026 Fountain Point Imaging Center • All Rights Reserved
Fountain Point Medical Community is an Equal Opportunity Employer.