Referrals

Washington Radiology requires a written order for all imaging studies to ensure WRA performs the proper exam to suit your medical needs. In addition, this extra measure makes certain that WRA distributes the interpretation to the appropriate referring physician responsible for the patient’s follow-up care. If a patient does not present with a written order, we will contact you to obtain confirmation of the study prior to initiating any patient care.

WRA has a library of pre-printed referral forms for you to use as needed. These forms capture the critical information WRA needs in order to know precisely what type of study should be performed. We also ask for a few comments about the patient’s history so that we can tailor the exam to the patient’s exact medical needs. However, WRA does accept any referring prescription which contains the following required fields: patient name, physician signature, date, type of exam, and patient history.

To request referral forms, please complete the following request, call the WRA Physician Outreach team at 703-573-5472, or email the outreach team. WRA offers the following materials for your use:

• Referral (Blue) Forms - English (pad of 25)
• Referral Forms - Spanish (pad of 25)
• MRI Referral Forms - English (pad of 50)
• Cardiac CT Angiography (pad of 50)
• PET/CT Referral Forms (pad of 25)
• Women's Health Studies (pad of 25)
• Patient Preparation Instructions For Contrast Studies - English (pad of 50)
• Breast Self-Exam Cards
• Insurance Participation List