| 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