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For Referring Physician

Dear Referring Physicians,

To refer a patient please simply download and print the referring physician form(s), and complete the information needed making sure the order is signed by the physician. Please FAX the order to: 541.382.6635; then have either your office staff or the patient call to schedule the procedure. If you are scheduling an exam that requires a contrast injection, a recent creatinine may be required prior to the exam. Some insurance companies may require pre authorization for certain procedures. If you have any questions please call our scheduling department at 541.382.9383 – we exist to serve you and your patients.

Referral Forms

• Central Oregon Radiology -X-Ray, Breast Imaging, Ultrasound, Nuclear Medicine
• Women’s Imaging Form
• Central Oregon MRI and Cascade Medical Imaging CT
• Cascade Medical Imaging, Westside -X-Ray, Mammography, Ultrasound and CT
• Cascade Medical Imaging, Redmond - X-Ray, Breast Imaging, Ultrasound and MRI
• Scheduling Request
• PACS Confidentiality, Web Ambassador & Users Guides