Cone Beam CT Imaging

Referring clinicians can download the PDF document of the "Cone Beam CT Imaging Referral Form", type the required information in each area of the form, print and sign the form, and then FAX the completed document to the SOD Radiology area (FAX 304-293-6386).

Cone Beam CT Imaging Referral Form


NOTE - the Cone Beam CT Imaging Referral Form requires the latest version of Adobe Reader. To download the latest version, please click here (link opens in new window).  Also, this form is best viewed using Internet Explorer.