Imaging Physician Order Forms

Refer a Patient

For ordering or scheduling questions, call 1.877.255.5654 or 303.398.1355, option 4.

View a list of our imaging tests.

 
Imaging Order Form

The order form is for all imaging studies; excluding echocardiograms and Nuclear Cardiac Studies. Please fill out all sections of the form. Authorization needs to be obtained prior to scheduling.

  • Download the order form (pdf) and fax it to scheduling at 303.270.2153.
  • A scheduler will contact the patient after your form is received.
  • For ordering or scheduling questions, call 303.398.1355, option 4..
Refer a Patient