Below you will find our radiology order forms in PDF format. To view and/or print these forms, you will need Adobe Acrobat Reader, which can be downloaded from www.adobe.com and used for free.
For patients being referred to our outpatint imaging sites: Bonney Lake, Puyallup, or Sunrise (Puyallup), please use the referral form link to access the most up-to-date referral form. To assure accuracy, this form should be completed and faxed to 253-446-3973 at least 48 hours before a scheduled procedure. For walk-in appointmennts, we encourage that the referral form be faxed, as well as hand-carried (by the patient) to the appropriate Imaging Center
To download a referral form click here: https://www.mydinw.com/index.php/PhysiciansClinicians/MakingReferrals/