DALLAS/FORT WORTH X-RAY ORDER FORM

Dallas/Fort Worth Area

Fax: 214-360-7701

orders@speedoflightxray.com

Download Order Form
Download Note

Order Form

Download Sample Order Form
Order Form

Download Sample Note

1. Call all orders into the Dallas office at 214-360-7707 (24/7) (365 days)

a. Please let us know if the order is a STAT order

2. Fax the following to 214-360-7701 these documents are required before we can dispatch technician

a. Face Sheet with all demographics for patient

b. Order must include:

i. Body part to be x-rayed with number AND type of views (please reference skeleton diagram)

ii. Reason for ordering exam (i.e. cough, sob, fall)

iii. Reason for PORTABLE exam (please reference portable explanation document)

c. Progress/clinical/communication note to support reason for ordering exam