SUNY Downstate Medical Center
Department of Radiology
For Referring Physicians
Radiology Request Form
For faster service please use the Radiology Information System (RIS) to order your study.
This request form is for services performed at the UHB campus only, and can be used by Physicians, Doctors of Osteopathic Medicine, Physician Assistants, Nurse Practitioners, and other clinicians.
The proper processing of requests depends upon the completion of pertinent medical and referrer information such provider NPI, pre-certification information if applicable, and patient history.