To request an appointment for your patient by fax, please print and return these forms:
Referring physicians - use this form to schedule a radiology appointment with our Phoenix Children's Medical Group Radiologists.
Radiology referral form (PDF)
Main number: (602) 933-1213
Radiology scheduling: (602) 933-1215 Fax: (602) 933-1214
Interventional scheduling: (602) 933-4444 Fax: (602) 933-1587
Surgeons - use this form when scheduling patients for surgery in Phoenix Children's operating rooms.
Surgery referral form (PDF)
Surgery Scheduling: (602) 933-1530
Surgery Fax: (602) 933-1553
Not sure about authorizations?
List of common procedures requiring authorization, listed by health insurance company (PDF)