For Clinicians

Clinicians who would prefer to use pre-printed documents and appointment cards, please contact the Marketing & Communication Program Director at (907) 212-6032.

Find a Form

Order Forms & Requisitions
Diagnostic Imaging Order Form497.7 KiB93
PET Order Form136.1 KiB29
Special Breast Procedures Order Form174.7 KiB36
CT Lung Cancer Screening Order610.1 KiB23
Prep Instructions
Barium Enema Prep Instructions61.7 KiB20
Barium Enema With Air Prep Instructions65.6 KiB23
Barium Enema Without Air Prep Instructions74.4 KiB32
CT Abdomen Pelvis Prep Instructions497.4 KiB44
Cyst Aspiration Prep Instructions93.8 KiB15
Ductogram Prep Instructions46.6 KiB19
MRI Preparation Screening Form210.1 KiB32
PET CT Bone Scan Prep Instructions157.7 KiB25
PET CT Brain Prep Instructions37.6 KiB22
PET CT Whole Body Prep Instructions71.8 KiB18
Small Bowel Series Prep Instructions92.1 KiB25
Stereo Imaging Guided Breast Biopsy Prep Instructions79.7 KiB24
Ultrasound Guided Thyroid Biopsy Prep Instructions35.6 KiB28
Ultrasound Guided Breast Biopsy Prep Instructions Copy79.7 KiB24
Upper GI Exam Prep Instructions78.2 KiB21
PET CT Prep Instructions V4163.9 KiB16
Ordering Guides
Breast Imaging Tip Sheet For Clinicians1.1 MiB37
Clinic Reference Card For Clinicians2.2 MiB24
CT Contrast Guide For Clinicians168.3 KiB39
Guide For Ordering CT Exams212.6 KiB15
Guide For Ordering MRI Exams175.6 KiB36
Guide For Ordering Ultrasound280.5 KiB26
Lung Cancer Guide For Clinicians48.7 KiB16

See all Forms here.

  • Auto-faxing of imaging reports to ensure quick turn-around time. A green-bordered “hard” copy of the report will also delivered via courier or mail. Contact us at (907) 212-6039 to arrange for autofax.
  • Access to a Radiologist is available to clinicians via telephone at (907) 212-3148, Monday – Friday, 8 a.m. – 5 p.m.


For a complete list of forms and other materials that you can download, click here.

Providence Alaska Provider Directory and Other Resources