Download referrals
and brochures

ARA’s referral order forms and patient exam brochures are available for your use via quick download below.

If you would like hard copies of these materials delivered to your practice, simply complete our Literature Request Form.

Referral Order Forms

• Adult Referral – English | Spanish
• CT Dental Scan Order Form – English
• CT Lung Screening Referral and Questionnaire – English
• I-131 Thyroid Treatment Referral – English
• Interventional Referral – English
• Provider Information and Locations – English
• Map & Locations (Patient) – English
• MRI Prostate Referral Form – English
• MSK Referral – English
• Neuroradiology Referral – English
• Pediatric Referral – English | Spanish
• PET/CT Prescheduling Form – English

Informational Flyers

• Contrast CT MRI Guidelines – English
• CT-MRI CPT Code Diagram – English
• PSMA (Pluvicto) Provider Information Flyer – English 
• PSMA (Pluvicto) Patient Information Flyer – English
• ARA Theranostics – A Guide for Patients – English
• ARA Locations & Insurance – English

Exam Brochures for Patients

• Abdominal Aortic Aneurysm Screening – English
• Abbreviated Breast MRI – English
• Bone Densitometry – English
• CT – English
• CT Calcium Scoring – English
• EVLT for Varicose Veins – English
• Hysterosalpingogram (HSG) – English
• Mammography – English | Spanish
• MRI – English
• Myelogram – English
• Peripheral Arterial Disease Treatment – English
• PET/CT – English
• Prostate Artery Embolization for Enlarged Prostate – English
• Stereotactic Breast Biopsy – English | Spanish
• Stop Smoking – English
• Ultrasound – English
• Ultrasound Guided Breast Biopsy – English | Spanish
• Uterine Fibroid Embolization – English
• Varicocele Embolization – English