For Physician Office Use:

Direct Admission Form

Pre-Admission Orders

Initial Pre-Op Procedure Adult Orders

Imaging

CPT Codes
Patient History and Contrast Administration Record
Radiology Requisition Form
Physician Survey

Imaging Procedures Preparation Instructions

Barium Enema 24hr Exam Prep
CT Abdomen and Pelvis with oral contrast and IV Exam Prep
CT Abdomen and Pelvis with oral contrast ONLY Exam Prep
Ultrasound Abdomen Exam Prep
Ultrasound Carotid Exam Prep
MRI Exam Prep
MRI Questionnaire

Nuclear Medicine Procedures

Bone Scan Exam Prep
Cerebral Perfusion Spect Exam Prep
Gallium Scan Exam Prep
Gastric Emptying Exam Prep
Gastrointestinal Bleed Exam Prep
Hepatobiliary Exam Prep
Liver Hemagioma Exam Prep
Liver Spleen Exam Prep
Lung VQ Exam Prep
Meckels Diverticulum Exam Prep
Muga Exam Prep
Myoview Cardiac Stress Test Prep
Parathyroid Exam Prep
Renal Exam Prep
Thyroid Uptake and Scan Exam Prep
White Blood Cell Exam Prep

Imaging Safety

MRI Safety

Radiation Safety

Click on the link below for radiation information on the various imaging procedures. 
This information is provided by the American Society of Radiologic Technologists.

Accreditation Facts