Refer a Patient: Pediatric Cardiac Imaging

1. Fill out the referral form

Download and complete the Cardiac MRI Scheduling Request form.

Download referral form

2. Send the form

Fax the completed form to Veronica Reyes, Pediatric Heart Center MRI coordinator, at (415) 353-4144.

1. Fill out the referral form

Download and complete the Radiology Central Scheduling form.

Download referral form

2. Send the form

Fax the completed form to (415) 353-7140.

3. Schedule an appointment

After we receive the fax, it takes about 15 minutes for the referral to enter our system. Then, either the patient or referring provider can call to schedule an appointment at (415) 353-2573.

1. Fill out the referral form

Download and complete the Diagnostic Imaging Referral form.

Download referral form

2. Send the form and any additional information

Fax the completed form to (510) 985-2202. You may also include an authorization (if required), medical record or operative notes, and diagnostic imaging or laboratory results.

For urgent appointments, please fax the form to either (510) 450-5837 (Oakland) or (925) 979-3404 (Walnut Creek).