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Physician Resources

  • PET for Oncology
  • PET for Neurology
  • PET for Cardiology
  • Research Protocols
  • PET and Insurance Coverage
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  • How to Refer a Patient
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If you want to refer a patient, please print, complete, and fax the appropriate form below to 318-675-4020.  For questions, please call 318-675-4042.

Oncology 

PET CT Oncology Referral Form.pdf

PET CT Bone Scan Referral Form.pdf

Xofigo Therapy Referral Form.pdf

Zevalin Therapy Referral Form.pdf

Neurology

PET Neurology Scan Referral Form.pdf

Cardiology

PET Myocardial Perfusion Referral Form and Related Information.pdf