Cedars-Sinai

Physician Imaging Request Form

For Medical Professionals Only

At this time we cannot accept the following procedure orders online: arthrograms, aspirations, biopsies, localizations, stress tests, or hysterosalpingograms (HSGs). Click here to select and print out the necessary form.

Please call (310) 423-8000.

Note: * indicates required fields.

If Patient is already scheduled:

Exam(s) Requested (please select at least one or more):

Physician Details

Send Duplicate Copies

By clicking the Submit Request button below, you will be sending your request to the S. Mark Taper Foundation Imaging Center at Cedars-Sinai.

Please review your information before submitting this request.

After you submit you will receive an encrypted copy of your order at the email address provided above. To view your confirmation, please click on the link in the email, create a password and retrieve your confirmation. You only need to create a password the first time you use the system.