Provider Guidelines and Requisition Forms

To help ensure smooth and timely care for your patients, we kindly ask that patients arrive for imaging services with the necessary requisition forms in hand. Having the correct documentation prepared in advance will prevent any delays and allow us to provide services more efficiently.

For CT, MRI, or Ultrasound appointments, please make sure the following are completed:

  • Requisition form
  • Pre-authorization
  • Lab results (if applicable)

With these documents, we can often schedule or provide services as early as the next day. Walk-in X-ray services are also available with a requisition form.

Requisition forms can be sent via fax to (808) 322-4576. If you have any questions, our scheduling team is happy to assist at (808) 322-4490.

You can download the necessary forms and learn more about imaging appointments here.