LACGH Patient Requisition Forms
Diagnostic Imaging
- Computed Tomography (CT) – Requisition #522
- External Consultation – Requisition #555
- Interventional Radiology (IVR) – Requisition #474
- Mammography and Bone Mineral Densitometery (BMD) – Requisition #66 (BMD Testing Guidelines)
- Ultrasound (General) – Requisition #476
- Ultrasound (Obstetrics) – Requisition #556
- X-Ray – Requisition #559