Send Referral - Santa Fe Imaging

(505) 983-9350

Got Your Order? Email it to IT_SUPPORT@santafeimaging.com

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Please enter number where you can be reached at. No hyphens.

Has Your Provider Ordered Your Exam *

PLEASE NOTE THAT IF YOUR PROVIDER HAS NOT FAXED, EMAILED, OR ELECTRONICALLY ORDERED YOUR EXAM, THEN WE CANNOT SCHEDULE YOUR APPOINTMENT

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Please upload physician referral if you have it

For Appointments 505-983-9350

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SAVE TIME! Please complete the form and we will call you to schedule an appointment. WE ARE EXPERIENCING HIGH INBOUND CALLS. AVOID THE WAIT!

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Type of Exam *

Mammography
MRI
XRAY
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Please check all that apply. Please note all X-RAY exams are walk-ins. If scheduling for mammogram, ask about same or next day appointments.

Has Your Provider Ordered Your Exam *

PLEASE NOTE THAT IF YOUR PROVIDER HAS NOT FAXED, EMAILED, OR ELECTRONICALLY ORDERED YOUR EXAM, THEN WE CANNOT SCHEDULE YOUR APPOINTMENT

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**NOTE: IF YOU HAVE EVER HAD PRIO IMAGING DONE FOR THE CURRENT BODY PART, WE WILL NEED THOSE IMAGES FOR COMPARISON. WITHOUT THOSE IMAGES, THERE COULD BE A DELAY IN REPORTING YOUR EXAM.