How to Schedule an
Outpatient Radiology Exam

1. Print your desired consultation request form.  Click on the "Consultation Request Forms" box to your left.

Fill out the request by:

• Providing the Attending and Ordering Physicians first and last names

• Have the Ordering physician sign the request (studies cannot be performed without a signature).

• Choose the desired exam(s) to be completed.

• Write clinical indications including signs and symptoms.

• Include pre-authorization number on the last line of the request form if required by the patient’s insurance company.

2. Fax the consultation request form to the appropriate number from below.

3. Call the appropriate scheduling number to schedule study.

OUTPATIENT RADIOLOGY SCHEDULING

If calling long distance, please use our 800 number which is
1-800-467-4882