MultiCare Health System

Main Phone Number800-342-9919   Online ChatOnline Chat
For Referring Providers and Staff

Making a Referral

Referring a patient to MultiCare Medical Imaging

To easily set-up an appointment for a patient, fax a completed referral form to our scheduling department or call the MultiCare Medical Imaging scheduling team.

Referral/Order Forms

For Pierce County - Allenmore Hospital, Allenmore Medical Building-C, Good Samaritan Hospital MultiCare Gig Harbor Medical Park, Tacoma General and Mary Bridge Children's Hospital

Common Exams (x-ray, fluroscopy, ultrasound, vascular ultrasound)

Specialty Exams (nuclear medicine, CT scan, MRI)

Breast Imaging and Bone Densitometry Exams (digital mammography, bone densitometry)

For South King County - Auburn MultiCare Health Center, Covington MultiCare Clinic , Kent MultiCare Clinic

Common Exams (x-ray, fluroscopy, ultrasound, vascular ultrasound, digital mammography, bone densitometry)

Specialty Exams (nuclear medicine, CT scan, MRI)

Please fax completed forms to our scheduling department.

The completed order form must include:

  • Written diagnosis/reason/symptom for the exam
  • Exam ordered
  • Referring provider name and signature 
  • Patient name
  • Date of birth
  • Insurance information