Referring for CT and Digital Scan

You may refer patients to our practice to have a CT & Digital Scan by filling out our CT & Digital Scan Referral Form. You can complete the form by either downloading the form or completing the fields below. If you download the form please complete all required areas and either email at [email protected] or fax to 410.820.8786. If you complete the form below using the fillable features please press the submit button at the bottom of the form when finished. Once we receive the form our office staff will make contact with the patient to make the reservation of the CT & Digital Scan and then contact your office with the information.