612 W. Duarte Rd., Suite 101
Arcadia, CA 91007
Live Operator: (626) 447-0035
Scheduling (626) 445-4850

Live Operator: (626) 447-0035

Scheduling (626) 445-4850

Live Operator: (626) 447-0035

Scheduling (626) 445-4850

Forms For Physicians
Radiology Forms for Physicians

Forms For Physicians

Quickly and conveniently access the necessary forms for referring your patients to Arcadia Radiology.

Forms For Physicians

Physicians, download the forms below when you refer your patients to Arcadia Radiology.

Referral Form

REFERRAL FORM

Physicians, use this form to request an imaging exam for your patient at Arcadia Radiology Medical Group or Arcadia Women's Imaging Center.

Medical Lien Form

MEDICAL LIEN FORM

Attorneys and Referring Physicians, use this form for your Medical Lien cases.

Medical Lien Form

PACS CONFIDENTIALITY AGREEMENT

Physicians, if you are a new PACS user, please read and sign our confidentiality agreement. Once we have received your signed agreement, we will provide you with access.