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Referral Forms

We have provided patient referral forms in PDF format so they can be printed out, completed and then either given to the patient to bring with on the day of the appointment or faxed to our office.

Acorbat PDF WIS Imaging Referral Form (For referring physician’s use only.)

Acorbat PDF Coronary Artery Calcium Exam (CACS) Referral Form (For referring physician’s use only.)

Acorbat PDF Sinus CT Exam Referral Form (For referring physician’s use only.)

Acorbat PDF PET/CT Scan Request Form (For referring physician’s use only.)

Acorbat PDF Chiropratic Referral Form (For referring physician’s use only.)


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Washington Imaging Services, LLC has advanced diagnostic imaging centers in Bellevue and Issaquah, Washington to serve patients on the greater Eastside and from Seattle. Our state-of-the-art PET/CT, MDCT, MRI, ultrasound and x-ray systems capture detailed images that our board certified subspecialty trained radiologists interpret to optimize clinical decision-making.

Washington Imaging Services, LLC, 1135 116th Ave. N.E., Suite 190, Bellevue, Washington 98004, 425.688.0100