When submitting images to Shield Radiology Consultants for interpretation with the generation of a formal radiology report, follow the instructions to ensure prompt service.
The Radiology Requisition
- Please read and completely fill out the patient information section and then sign the Shield Radiology Requisition Form. When appropriate, a parent / guardian or staff member can completely fill out the patient information section and then have the responsible party sign the Shield Radiology Requisition Form.
- Have your office staff complete the billing section of the Shield Radiology Requisition form.
- The referring physician can then make or attach specific notes of any concerns or significant past medical history.
- The images and completed paperwork can then be submitted to Shield Radiology Consultants for interpretation and the generation of a formal radiology report.
The Submission & Report
- Contact our office about convenient weekly door to door courier service in the Las Vegas area.
- Your digital image submission can be uploaded into our cloud based AMPLIFY PACS system account. We will return the formal report via our HIPAA compliant Drop Box account, facsimile or priority US mail.
- Your digital image submission and completed paperwork can be placed into a HIPAA compliant Drop Box account. We will return the formal report through the same Drop Box account.
- Your flat film or digital image media submission can be mailed to our office utilizing our pre-paid mailing packets. We will return everything utilizing U.S. Priority mail.
When filling out the Shield Radiology Requisition form it is important to be thorough with the patient history, noting previous surgeries and or any significant past medical history. The radiology requisition serves as an informed consent, release of information, assignment of benefits, and a doctor’s lien.
Our board certified radiologists are Diplomates of the American Chiropractic Board of Radiology and licensed in Nevada and Utah.