REFERRAL FORM

Please download ( doc , pdf ) and print the FDG referral form, fill it out on your patients, and FAX it to us at (415) 921-7225.

ESSENTIAL PATIENT PREPARATION

1) The CT scan uses special x-ray equipment to obtain image data from different angles around the body. When the image slices are assembled by computer, the result is a very detailed, multidimensional view of the body's interior.
2) Patients should fast (no food) for at least four (4) hours prior to their appointment. However, drinking water is permitted right up to the time of the appointment.
3) Wear comfortable, loose-fitting clothing. Metal objects can affect the image, so avoid clothing with zippers and snaps.
4) Contrast may be given by injection to define blood vessels and organs (kidney, liver, spleen), enema (colon) or oral (stomach, small bowel and colon).
5) You may be asked to wait until the images are examined to determine if more images are needed.
6) The CT scan can take from 5 minutes to 60 minutes. Injected and enema contrast require no wait for scanning. Oral contrast requires approximately 60 minutes wait prior to CT scan.
7) CT scanning causes no pain, is noninvasive and accurate, identifying normal from abnormal structures.
8) A Board Certified Radiologist, who is a physician, will analyze the images and send a signed report to your personal physician.
9) Contraindications: This study shouldn't be performed on pregnant or breast-feeding individuals. Please inform staff or the Technologist if you are pregnant or breast-feeding (wait 24 hours).