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PreAuthorization for Providers
>University Radiology will not perform exams on patients with known or suspected Covid–19.
All patients will be screened at their appointment time and will need to be rescheduled if they fail the verbal screening / temperature check. Click here for more information on what to expect for your exam.
Included in the links below are preparation instructions for our most commonly prescribed exams. If you are preparing for a specific exam, please follow these and your physician or health care provider’s instructions carefully. If you have questions, please contact us at 800-758-5545.
Below are the common forms that may need to be completed prior to your exam. For your convenience we now provide a Mobile/Online option that can be completed from your phone, tablet or PC without printing.
Or you can still choose to print out the form(s) and bring them with you to your appointment.
| Questionnaire | Online | Printable |
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| Medical History | Online | Printable |
| MRI | Online | Printable |
| MRI/CT Neuro | Online | Printable |
| MRI/CT MSK | Online | Printable |
| MRI Female Pelvis | Online | Printable |
| MRI Prostate | Online | Printable |
| CT Scan Sinus | Online | Printable |
| Dexa | Online | Printable |