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Imaging Service Referrals

How to refer patients to Imaging Services

Our goal is to create a seamless experience for Atlanta physician referral through partnership, education, communication and preparation.

Three ways to refer patients:

  • Download and print our Imaging Services Order Form, then fax the completed form to us at 404.501.1743.
  • Complete all boxes/lines on the form, scan it and save it to your PD as a PDF (requires complete Adobe Acrobat software), then fax to us at 404.501.1743.
  • Order by phone at 404.501.7243. (Note: you will still need to complete and fax the referral form.)

Expediting your physician referral


  • Patient name - Print the patient’s name legibly, and distinguish between first and last names. We file or “index” our orders alphabetically.
  • Phone numbers - Provide current daytime contact information.
  • DOB and Social Security numbers – Accurate information helps us confirm that we have the correct patient.
  • Referring physician - Print the referring physician’s name legibly. If we need to contact him/her, this is where we look first for contact information.
  • Physician signature - Georgia law requires a physician signature on all orders. We cannot accept orders signed by Physician Assistants.
  • Special requests - Indicate if you prefer film or CD images sent with your patient. (All studies are available on the PACS system.)
  • Exams – We are only able to precertify and perform studies exactly as the physician office has scheduled the exam. If you have questions about the exam or whether to use contrast, call 404.501.2675 or contact us.
  • Please provide symptoms and/or diagnoses for the study ordered. Do not use “rule out” (R/O).

For additional ordering guidelines, call 404.564.5400, ext. 16.


  • Before scheduling, consider when clinical notes will be provided to our precert team. We schedule patients based on their insurance company’s precertification turnaround time. Some companies require 72 hours once they have the clinical notes.
  • “Please call patient to schedule” (upper-right corner of form) - If you check this option, we will contact the patient and schedule his/her appointment. Provide patient’s current daytime phone number(s) and please call patient beforehand to advise that we will be attempting to contact him/her.
  • “Patient already scheduled” – Check this option if your office has already called and scheduled your patient.
  • Confirmation of appointment – If we have contacted your patient to set an appointment, we will fax you a confirmation of the appointment date and time. If we are unable to reach your patient after three attempts, we will alert you by fax. We will not make additional attempts to reach your patient until we receive updated contact information from you.


To complete your order, Emory Hillandale’s precertification team requires clinical notes and/or clinical information, such as test results, previous treatments, etc. We also may need your Federal tax ID number. To expedite the precert process and minimize follow-up phone calls to your office, please fax all pertinent clinical information as soon as possible after scheduling to 404.501.1743.

We consider the scheduling process incomplete unless we have:

  • A legible, complete order
  • Demographic information
  • A copy of the patient’s insurance card (front and back)
  • Clinical notes and patient history for precert and for the radiologist’s
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