Resources for Referring Providers
At Capitol Imaging Services (CIS), we are dedicated to providing referring providers with state-of-the-art technology, professional expertise, and patient-centered care. To streamline the referral process, our resources for referring providers page offers a series of links and forms designed to help you quickly and efficiently refer patients, submit order forms, request service referral pads, and access key information about each facility’s equipment and capabilities. You will also find guidelines for exam criteria, titles, codes, and recommended wording to ensure accuracy in ordering.
Fillable Referral Order Forms
The Capitol Imaging Services Fillable Referral Order Form is used in place of the traditional paper order form. Many of our referral partners prefer to fill out this editable PDF and save it directly to their EMR system. This document may also be attached to the electronic referral order form below.
Fillable Referral Order Forms
Submit Referral Order
The Submit Referral Order Form is an electronic referral order form to be sent to the CIS location of your choice. You may also attach the above Fillable Referral Order Form to this form as well.
Submit Referral Order
REFERRAL Order Pads
Referral Order Pads are used by referring providers to order imaging exams. Providers can request referral pads by clicking the button below, and a we will deliver them directly to your office.
Request Order Pads
Referrer Info Packet
The Referrer Information Packet provides details on each CIS location's contact information, available imaging equipment and the speciality exams performed at each location.
Referrer Info Packet
Locations &
Technology
The Locations & Technology guide below provides a list of all CIS locations, their phone/fax numbers, and the imaging equipment at each location.
View Affiliates
Radiology Ordering Guide
The Radiology Ordering Guide provides essential information for imaging exams, including possible reasons for the exams, if contrast is required and then what type of contrast, along with procedure descriptions and CPT codes.
Radiology Ordering Guide
ACR Imaging Appropriateness Criteria
The ACR Imaging Appropriateness Criteria is a collection of downloadable evidence-based guidelines designed to assist referring physicians and other healthcare providers in making the most appropriate imaging exam decisions for specific clinical conditions.
ACR Imaging Appropriateness Criteria
