Easy On-Line Ordering
Click here to order
All orders are completely free of charge to our referring practices!
A list of what is available is below.
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University Imaging Requisitions
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Universal requisitions - used for all imaging studies at any University Imaging location. For use by all referrers (except article 28 clinics). 50 sheets/pad |
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Universal APG requisitions - used for all imaging studies at any University Imaging location. For use by article 28 clinics only. 50 sheets/pad |
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Breast Imaging requisitions - Breast imaging requisition for any University Breast imaging location. For use by all referrers. 50 sheets/pad |
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Patient Information Sheets
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CT information - Patient information sheet about CT (computed tomography) studies with health history form on back. For use by all referrers. 50 sheets/pad. |
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MR information - Patient information sheet about MR (magnetic resonance) studies with health history form on back. For use by all referrers. 50 sheets/pad. |
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Nuclear Medicine information - Patient information sheet about Nuclear Medicine studies with health history form on back. For use by all referrers. 50 sheets/pad. |
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Interventional Radiology information - Patient information sheet about Interventional Radiology studies with health history form on back. For use by all referrers. 50 sheets/pad. |
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GI information - Patient information sheet about Gastrointestinal studies with health history form on back. For use by all referrers. 50 sheets/pad. |
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US information - Patient information sheet about Ultasound studies. For use by all referrers. 50 sheets/pad. |
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University Imaging Maps
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Includes maps and directions to all University Imaging locations. 50 sheets/pad. |
Your order will be free of charge and will be delivered by the end of the following week.
Contact: Kathy Simmons, Director of Business Development, at 585-275-4570










