Adult CT Scan

Ordering Instructions

If contrast is ordered:

  • BUN and creatinine are required within 30 days before the exam if the patient is diabetic, or is more than 60 years, or has a history or renal insufficiency.Prep Instruction
  • Metformin medications need to stop on the appointment day and for 48 hours after the exam. Please consult with your patient.
  • Allergy prep is required the patient has a known iodine contrast allergy or history of allergic reactions during injection of intravenous contrast. Please call CT clinical triage if unsure: 909-558-0944

Ordering Forms

The exam request form is interactive. You should type information in the free text fields and select the requested exams from the drop down menus.  

For example:

Complete the form, print, sign and fax according to the information at the bottom of the page.