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 KiB41
PET Order Form136.1 KiB12
Special Breast Procedures Order Form174.7 KiB15
CT Lung Cancer Screening Order610.1 KiB5
Prep Instructions
Barium Enema Prep Instructions61.7 KiB9
Barium Enema With Air Prep Instructions65.6 KiB11
Barium Enema Without Air Prep Instructions74.4 KiB11
CT Abdomen Pelvis Prep Instructions497.4 KiB18
Cyst Aspiration Prep Instructions93.8 KiB8
Ductogram Prep Instructions46.6 KiB9
MRI Preparation Screening Form210.1 KiB12
PET CT Bone Scan Prep Instructions157.7 KiB13
PET CT Brain Prep Instructions37.6 KiB9
PET CT Whole Body Prep Instructions71.8 KiB8
Small Bowel Series Prep Instructions92.1 KiB13
Stereo Imaging Guided Breast Biopsy Prep Instructions79.7 KiB14
Ultrasound Guided Thyroid Biopsy Prep Instructions35.6 KiB13
Ultrasound Guided Breast Biopsy Prep Instructions Copy79.7 KiB12
Upper GI Exam Prep Instructions78.2 KiB14
PET CT Prep Instructions238.8 KiB4
Ordering Guides
Breast Imaging Tip Sheet For Clinicians1.1 MiB18
Clinic Reference Card For Clinicians2.2 MiB10
CT Contrast Guide For Clinicians168.3 KiB13
Guide For Ordering CT Exams212.6 KiB7
Guide For Ordering MRI Exams175.6 KiB15
Guide For Ordering Ultrasound280.5 KiB13
Lung Cancer Guide For Clinicians48.7 KiB10

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