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Physician Referral Information and Forms

Ordering a Diagnostic Imaging or Interventional Radiology Study

Ordering a study or interventional procedure with Northern Virginia Radiology Consultants is easy. Simply download either the Diagnostic Imaging Referral Form, or the Interventional Procedure Request Form, fill it out, and fax it to our scheduling office.

If you would like a pad of forms for your office, NVRC will provide them for you.  Please contact Henry Espinales at (703) 558-3222 to request your NVRC referral forms.

Diagnostic Imaging

Scheduling Line: 703-558-8500
Scheduling Fax: 703-358-9638

Download Diagnostic Referral Forms

Interventional Radiology

Scheduling Line: 703-558-6533
Scheduling Fax: 703-558-6252

Download Interventional Procedure Forms


PACS Access

Referring physicians may request access to our PACS system to review their patients images from the convenience of their office.

In order to obtain PACS access, the physician must be a member of the medical staff at the Virginia Hospital Center.  Physicians may access the PACS system through the web portal.

For additional assistance with the web portal and viewing images, please contact the Virginia Hospital Center Physician liason,

, or contact her office directly at 703-558-5945.

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