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Making Referrals
Order Forms
Download the Breast Imaging & Bone Density Form
Download the Common Exams Referral Form
Download the Specialty Exams Referral Form
Download the Vascular Ultrasound Referral Form
Download the Exam Prep Sheet
Download the Location Maps
The referral slip is like a prescription. If the right information is not on the slip we will have to call you back. According to Medicare this is what constitutes a referral:
- Written diagnosis/reason/symptom for the exam
- Procedure/procedure ordered
- Referring provider name
- Patient name
- Date of birth
The order must be sent on a prescription or referral pad with a signature if it is not sent electronically. Having a properly completed document in advance will expedite the appointment and improve the patient's experience. Having it completed properly will keep us from calling you and tying your staff up on the phone. Please complete the form properly.
Make sure to FAX the completed Radiology Order Form before the appointment.
- Do not rely on the patient remembering to bring it with them.
- Please indicate if there are prior films or surgical reports that we should have in advance.
- When possible avoid scheduling routine appointments during peak times such as during the lunch hour or at the end of the day.
- Be sure that the patient has enough time between the imaging procedure and the follow-up appointment with the referring physician. This will allow the radiologist to review and interpret the patient's results in plenty of time for the follow-up visit.
Remind patients to arrange for childcare before coming. There are no childcare services onsite. Due to the presence of radiation, children are not allowed to enter patient rooms with their parents during imaging procedures.
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