print

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.

  • University Imaging Requisitions

access guide

Universal requisitions - used for all imaging studies at any University Imaging location. For use by all referrers (except article 28 clinics). 50 sheets/pad

Universal APG requisitions - used for all imaging studies at any University Imaging location. For use by article 28 clinics only. 50 sheets/pad

Breast Imaging requisitions - Breast imaging requisition for any University Breast imaging location. For use by all referrers. 50 sheets/pad

  • Patient Information Sheets

CT information - Patient information sheet about CT (computed tomography) studies with health history form on back. For use by all referrers. 50 sheets/pad.

MR information - Patient information sheet about MR (magnetic resonance) studies with health history form on back. For use by all referrers. 50 sheets/pad.

Nuclear Medicine information - Patient information sheet about Nuclear Medicine studies with health history form on back. For use by all referrers. 50 sheets/pad.

Interventional Radiology information - Patient information sheet about Interventional Radiology studies with health history form on back. For use by all referrers. 50 sheets/pad.

GI information - Patient information sheet about Gastrointestinal studies with health history form on back. For use by all referrers. 50 sheets/pad.

US info

US information - Patient information sheet about Ultasound studies. For use by all referrers. 50 sheets/pad.

  • University Imaging Maps

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